Related Experiment Video
Updated: Jul 9, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
A potential catastrophic trap: an unusually presenting sellar lesion
M Locatelli1, D Spagnoli, M Caroli
1Neurosurgical Department, Fondazione Ospedale Maggiore IRCCS, Policlinico Mangiagalli e Regina Elena, University of Milan, Milano, Italy.
European Journal of Neurology
|November 29, 2007
Summary
A rare case of internal carotid artery aneurysm thrombosis mimicked pituitary apoplexy. Magnetic resonance imaging (MRI) and angiography confirmed the diagnosis, suggesting conservative treatment for similar cases.
Area of Science:
- Neurology
- Vascular Surgery
- Endocrinology
Background:
- Pituitary apoplexy, a rare endocrine emergency, typically presents with sudden headache, visual impairment, and ophthalmoplegia.
- Sellar region lesions on magnetic resonance imaging (MRI) can represent various pathologies, including pituitary adenomas, aneurysms, and other tumors.
- Differentiating pituitary apoplexy from other sellar masses is crucial for appropriate management.
Observation:
- A 63-year-old man presented with headache, vomiting, and vertigo.
- Brain MRI revealed an expanding sellar region lesion.
- Cerebral angiography identified a thrombosed intracavernous internal carotid artery aneurysm.
Findings:
- This case represents the first documented instance of a thrombosed intracavernous carotid artery aneurysm mimicking pituitary apoplexy, diagnosed via MRI and angio-MRI.
- The patient's symptoms and imaging findings were initially suggestive of pituitary apoplexy.
- Cerebral angiography was essential in revealing the underlying vascular pathology.
Implications:
- The findings challenge the typical presentation and diagnostic pathway for pituitary apoplexy.
- This case supports conservative management for pituitary apoplexy, particularly when intracavernous extension or invasion limits surgical options.
- Accurate diagnosis through advanced imaging is critical to avoid misdiagnosis and ensure optimal patient outcomes.
