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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Iatrogenic traumatic intracranial aneurysm after endoscopic sinus surgery
Joshua Wewel1, Erwin Zeta Mangubat1, Lorenzo Muñoz1
1Rush Professional Office Building, 1725 W. Harrison Street, Suite 855, Chicago, IL 60612, USA.
Summary
Iatrogenic intracranial aneurysms from endoscopic sinus surgery are rare but serious. This case highlights complex management involving endovascular coiling and surgical repair of a pseudoaneurysm and skull base defect.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Otolaryngology
Background:
- Iatrogenic intracranial aneurysms are uncommon but pose significant risks.
- Endoscopic sinus surgery, while common, carries potential vascular risks.
Observation:
- A patient with chronic sinusitis developed a pseudoaneurysm of the left anterior cerebral artery A2 segment during endoscopic polypectomy.
- The injury resulted in a complex intracranial and skull base defect.
Findings:
- Successful management involved a multi-modal approach.
- Endovascular coiling was used to treat the pseudoaneurysm.
- A bicoronal craniotomy with cranial and fat grafts repaired the cribriform plate defect.
Implications:
- This case underscores the importance of vigilance for vascular injury during endoscopic procedures.
- Complex iatrogenic aneurysms may require combined endovascular and open surgical techniques.
- Multi-disciplinary collaboration is crucial for optimal patient outcomes.
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