Unruptured Internal Carotid Artery Aneurysm Associated with Functional Pituitary Adenoma: A True Association

Detection of incidental intracranial aneurysm on neuroimaging can be associated with pituitary adenoma; however, such association is extremely rare. However, aneurysm with extension into the sella is extremely rare, and increases the risk of inadvertent intraoperative rupture, if trans-sphenoidal decompression is attempted either using endoscopic or microscopic surgical approach. Hanak et al. in a literature review of intrasellar noniatrogenic aneurysms over PubMed search in 2012 could only collect 31 studies, of which only eight cases had pituitary adenoma associated with aneurysm extending into sella. Authors report an interesting case of 52-year-old male diagnosed as case of acromegaly, was put on dopamine agonist, bromocriptine and responding well to therapy, however the magnetic resonance imaging raised suspicion of vascular pathology, and underwent digital subtraction angiography at our center revealed presence of right supracliniod internal carotid aneurysm, which was coiled using endovascular technique with resultant good outcome.