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Updated: Aug 8, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Carotid cavernous aneurysm presenting as pituitary apoplexy
A Romano1, S Chibbaro, M Marsella
1Department of Neurosurgery, Palma University Hospital, Palma, Italy.
Summary
A ruptured internal carotid artery aneurysm mimicked a pituitary adenoma, causing sellar hematoma. Prompt diagnosis and surgical clipping led to full recovery, highlighting crucial differential diagnosis in acute neurological presentations.
Area of Science:
- Neurosurgery
- Neuroradiology
- Endocrinology
Background:
- Ruptured internal carotid artery aneurysms can present with complex symptoms.
- Sellar hematomas can mimic pituitary adenomas on imaging.
- Pituitary apoplexy is a clinical emergency requiring prompt evaluation.
Observation:
- A 53-year-old woman presented with headache, vomiting, ophthalmoparesis, and hemiparesis.
- Brain MRI revealed a sellar mass suggestive of pituitary macroadenoma.
- Cerebral angiography identified a carotid cavernous aneurysm.
Findings:
- The sellar mass was confirmed as a hematoma, not a pituitary adenoma.
- The internal carotid artery aneurysm was successfully clipped via a subfrontal approach.
- The patient experienced significant neurological recovery post-surgery.
Implications:
- This case underscores the importance of considering vascular lesions in sellar region masses.
- Accurate differential diagnosis is critical for appropriate management of acute sellar region pathology.
- Multidisciplinary surgical and radiological approaches are vital for favorable outcomes.
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