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Updated: Apr 29, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

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Large intracranial aneurysm after transsphenoidal surgery for pituitary macroadenoma

Kyeong-Wook Yoon1, Chun-Sung Cho1, Sang-Koo Lee1

  • 1Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.

Journal of Korean Neurosurgical Society
|May 23, 2014
PubMed

Insights

Cerebrospinal fluid (CSF) leakage after pituitary adenoma surgery can cause meningitis. This case highlights a rare, large ruptured mycotic pseudoaneurysm resulting from such infection, emphasizing a unique complication pathway.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Neuroradiology

Background:

  • Transsphenoidal surgery (TSS) for pituitary adenomas can lead to cerebrospinal fluid (CSF) leakage.
  • CSF leakage is a known risk factor for meningitis.
  • Mycotic pseudoaneurysms are rare intracranial complications of central nervous system infections.

Observation:

  • A patient developed a large, single, ruptured mycotic pseudoaneurysm.
  • The complication arose from a cerebral infection secondary to CSF leakage post-TSS for a pituitary macroadenoma.
  • The patient had no history of endocarditis or other cardiac issues typically associated with mycotic aneurysms.

Findings:

  • This case presents an uncommon etiology for a large mycotic pseudoaneurysm, directly linked to post-surgical CSF leakage.
  • The infection pathway bypassed typical sources like endocarditis, originating from the surgical site.
  • Rupture of the pseudoaneurysm represents a critical and potentially life-threatening event.

Implications:

  • Highlights the risk of serious vascular complications from seemingly controlled CSF leaks after TSS.
  • Suggests vigilance for mycotic pseudoaneurysms in patients with post-TSS CSF leakage and signs of infection.
  • Underscores the need for prompt diagnosis and management of intracranial infections following pituitary surgery.
Keywords:
Intracranial aneurysmPituitary macroadenomaTranssphenoidal surgery

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