A rare case of a giant, thrombosed, sellar-suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar-suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm.

Aneurysmal bone cyst are benign rapidly expanding bone destructive lesions of any bone. They are common in the metaphysis of long bones but 10-30% involve the spine. Cervical region involvement is uncommon. We report a case of aneurysmal bone cyst of clivus C1 and C2 with minimum symptoms. Involvement of C1 and clivus separately had been reported in past, but simultaneous involvement of both is presented in this report for the very first time.KeywOrds: Aneurysmal bone cyst, Spine, Clivus ÖZAnevrizmal kemik kistleri herhangi bir kemikte görülebilen iyi huylu ancak tutmuş olduğu kemikte hızla genişleme yaparak harabiyete neden olur. Uzun kemiklerin metafizlerini yaygın olarak tutmakla beraber yüzde 10-30 oranında omurgada tutulum yapabilir. Servikal bölge tutulumu nadirdir. Klivus, servikal 1 ve 2. omurlarında anevrizmal kemik kistine bağlı tutulumu olan ve minimal semptomu olan hasta olgu olarak sunulmaktadır. Geçmişte, clivus veya servikal 1. omurun anevrizmal kemik kisti ile tutulumu ayrı vakalar halinde sunulmuştur, bizim olgumuz ise eşzamanlı olarak klivus ve servikal 1-2 omurgalarının aynı olguda tutulması ilk kez sunulmaktadır.

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Congenital deformities involving the coverings of the nervous system are called neural tube defects (NTDs). NTD can be classified as neurulation defects, which occur by stage 12, and postneurulation defects. Cervical meningocele and myelomeningocele are rare spinal dysraphic lesions. Unlike lumbosacral dysraphic lesions, there is often no neurologic deficits and thus the subtle features of cervical cord tethering may be overlooked on imaging. The presence of meningomyelocele and/or encephaloceles at multiple (two or more) sites along the vertebral axis is a very rare event occurring in <1% of cases. Less than 10 cases have been described in the published literature. We are reporting a case of multiple NTD in same patient with no neurological deficit.

A significant association of MMP-2 (-1306C/T) polymorphism with GBM (P = 0.475) was not found, suggesting that MMP-2 (-1306C/T) polymorphism is not associated with increased GBM susceptibility.