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Related Experiment Videos

[Giant parasellar aneurysm simulating pituitary tumor].

L A da Motta1, M de N Hermes Júnior, M A Figueiredo

  • 1Núcleo de Neuroendocrinologia, Unidade de Neurocirurgia, Hospital de Base do Distrito Federal, Brasilia, Brasil.

Arquivos De Neuro-Psiquiatria
|December 1, 1988
PubMed
Summary

Giant aneurysms, often of the intracavernous carotid artery, can compromise the pituitary fossa. Progressive occlusion of the internal carotid artery offers promising results for these challenging cases.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Pituitary fossa abnormalities on skull X-rays can indicate serious underlying vascular pathology.
  • Giant aneurysms, particularly of the intracavernous carotid artery, present diagnostic challenges.

Observation:

  • Seven cases of pituitary fossa compromise due to giant aneurysms (6 intracavernous carotid artery, 1 anterior communicating artery) were analyzed.
  • Common symptoms included headache, ophthalmoplegia (cranial nerves III, IV, VI), trigeminal nerve (V) compromise, and ocular pain.
  • Less frequent signs included meningeal signs, blindness, hemiparesis, cacosmia, and visual field defects.

Findings:

  • Five patients with intracavernous carotid artery aneurysms benefited from progressive cervical internal carotid artery occlusion.

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  • One patient with an anterior communicating artery aneurysm improved after surgical clipping.
  • Cerebral angiography is crucial for accurate diagnosis of parasellar aneurysms.
  • Implications:

    • The differential diagnosis of parasellar aneurysms is complex, requiring advanced imaging.
    • Progressive occlusion of the internal carotid artery is a low-risk, effective treatment for selected intracavernous aneurysms.
    • Early diagnosis and appropriate surgical intervention are key to managing these potentially life-threatening conditions.