Internal Carotid Artery Dissection Associated with Pituitary Apoplexy

Provenzale, James M.; Hacein‐Bey, Lotfi; Taveras, Juan M.

doi:10.1097/00004728-199501000-00031

Cited by 11 publications

(6 citation statements)

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“…These include internal carotid artery (ICA) aneurysm rupture,[2023] ACoA artery aneurysm rupture,[22] and ICA dissection. [18] Bilateral ICA unruptured aneurysms[25] and thrombosis of an intracavernous aneurysm[14] have also been reported to mimic apoplexy. Finally, there have been cases of ruptured aneurysms with associated pituitary tumors that have caused apoplexy.…”

Section: Discussionmentioning

confidence: 99%

Posterior communicating artery aneurysm rupture mimicking apoplexy

Bonfield

Gardner²

2011

Surg Neurol Int

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Background:Cerebral aneurysm rupture can lead to devastating neurological complications and present a complex problem to treat. We report a unique case of a ruptured posterior communicating artery (PCoA) aneurysm presenting with sudden and complete vision loss.Case Description:A 39-year-old man presented with the acute onset of severe headache and complete bilateral vision loss. The patient described headaches for several months prior to presentation. However, prior to the day of presentation, he had no visual disturbance. A CT angiogram (CTA) and magnetic resonance imaging (MRI) of the brain revealed a 1.6-cm, non-contrast enhancing suprasellar mass, eccentric to the left side, consistent with hemorrhagic mass. There was no obvious aneurysm or vascular malformation. The sella tursica was normal in appearance. The patient was taken for an immediate endoscopic endonasal transtuberculum approach for optic nerve decompression. Hematoma without an associated tumor was encountered and partially evacuated before aborting with resultant partial improvement in vision. A subsequent cerebral angiogram revealed an irregularly shaped, postero-laterally pointing, 2.5-mm left PCoA aneurysm. The patient was then taken for open clipping of the ruptured aneurysm. A large, fibrinous capsule was found over the superolateral aspect of the aneurysm. The ruptured aneurysm was secured with clips and the surrounding hematoma was evacuated.Conclusion:In the immediate postoperative period, the patient regained vision in the nasal field of his right eye. This case illustrates a unique presentation of a ruptured PCoA aneurysm, and thus must be considered in the differential diagnosis of a suprasellar hemorrhage resulting in visual loss in absence of a recognizable associated tumor.

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Section: Discussionmentioning

confidence: 99%

Posterior communicating artery aneurysm rupture mimicking apoplexy

Bonfield

Gardner²

2011

Surg Neurol Int

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“…[11][12][13][14][16][17][18] In other reports, cerebral aneurysms mimic or are mistaken for pituitary tumours. These patients present clinically with various symptoms and signs, related sometimes to the aneurysm mass effect, to aneurysm rupture, or to the macroadenoma, and sometimes to both pathologies.…”

Section: Discussionmentioning

confidence: 99%

“…5,13 We believe that angiography, in selected cases, can still play a major role in investigating vascular lesions in the sellar region and in planning optimum surgical management. The recent literature generally states that routine angiography is no longer indicated.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] It is clinically characterised by sudden onset of headache and impaired consciousness, often accompanied by vomiting, and fre-quently followed by visual disturbance and/or a variable degree of oculomotor nerve palsy. [11][12][13][14] Sellar aneurysms may mimic pituitary tumours by producing endocrine disturbance, including hypo-or selective hyperpituitarism and by compressing adjacent cranial nerves. [11][12][13][14] Sellar aneurysms may mimic pituitary tumours by producing endocrine disturbance, including hypo-or selective hyperpituitarism and by compressing adjacent cranial nerves.…”

Section: Introductionmentioning

confidence: 99%

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Carotid cavernous aneurysm presenting as pituitary apoplexy

Romano¹,

Chibbaro²,

Marsella³

et al. 2006

Journal of Clinical Neuroscience

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“…1,2 However, the exact mechanism of pituitary apoplexy is not always clear. 1,2 Recently, Provenzale et al 3 reported a case in which pituitary apoplexy occurred probably secondary to internal carotid artery (ICA) dissection. We present a case of pituitary apoplexy caused by an unsuspected aneurysmal bleeding into a pituitary adenoma.…”

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confidence: 99%

Pituitary Apoplexy Caused by Ruptured Internal Carotid Artery Aneurysm

Suzuki

Muramatsu

Murao

et al. 2001

Stroke

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Background and Purpose-We report the first case of pituitary apoplexy caused by the rupture of an intracavernous carotid artery aneurysm embedded in a pituitary adenoma. Case Description-A 46-year-old man presented with clinical and CT findings typical of pituitary apoplexy. MRI showed an unusual flow-void protrusion into the intratumoral hematoma, which, however, was not diagnosed as a ruptured aneurysm until severe intraoperative bleeding occurred. Angiography after surgery revealed an intracavernous carotid artery aneurysm. Conclusions-The

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Internal Carotid Artery Dissection Associated with Pituitary Apoplexy

Cited by 11 publications

References 0 publications

Posterior communicating artery aneurysm rupture mimicking apoplexy

Posterior communicating artery aneurysm rupture mimicking apoplexy

Carotid cavernous aneurysm presenting as pituitary apoplexy

Pituitary Apoplexy Caused by Ruptured Internal Carotid Artery Aneurysm

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