Bilateral carotid aneurysms unmasked by severe hypopituitarism

We describe a patient who initially presented with severe hyponatraemia and grand mal seizures, without any focal neurological symptoms. The final diagnosis was that of giant bilateral carotid aneurysms extending into the sella turcica with anterior hypopituitarism. To the best of our knowledge, this is the first case report of symmetrical carotid aneurysms manifested exclusively by an acute endocrine emergency with none of the concomitant usual focal signs such as headache, failing vision, oculomotor palsy or subarachnoid hemorrhage.