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Endoscopic approach to cavernous sinus aneurysm.

Savas Ceylan¹, Ihsan Anik, Kenan Koc

¹Kocaeli University, Pituitary Research Centre, Department of Neurosurgery, Kocaeli, Turkey. ssceylan@yahoo.com

Turkish Neurosurgery

|June 13, 2013

Summary

This summary is machine-generated.

Carotid-cavernous aneurysms can mimic pituitary tumors, potentially causing severe headaches and vision problems. Prompt surgical intervention, including hematoma removal, led to symptom improvement in a patient initially misdiagnosed with pituitary apoplexy.

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Area of Science:

Neurosurgery
Neuroradiology
Endovascular Therapy

Background:

Aneurysms within the sella turcica can compress cranial nerves, mimicking pituitary adenomas.
Carotid-cavernous aneurysms, though rarely fatal, warrant intervention for neuro-ophthalmologic progression.

Observation:

A 51-year-old woman presented with severe headache and neuro-ophthalmologic deficits, initially suspected as pituitary apoplexy via Magnetic Resonance Imaging (MRI).
Computed Tomography Angiography (CTA) revealed a carotid-cavernous aneurysm protruding into the sella, causing mass effect.

Findings:

The patient underwent successful endovascular intervention and endoscopic transsphenoidal hematoma evacuation.
Post-procedure, the patient experienced significant improvement in neuro-ophthalmologic symptoms.

Implications:

This case highlights the importance of advanced imaging like CTA in differentiating aneurysms from pituitary tumors.
Timely surgical decompression of the hematoma is crucial for resolving cranial nerve compression and improving patient outcomes.
Endovascular and surgical approaches can be effectively combined for managing complex carotid-cavernous aneurysms presenting in the sellar region.