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Marked hyperprolactinemia caused by carotid aneurysm

S R Kahn1, R Leblanc, A F Sadikot

  • 1Department of Medicine, Royal Victoria Hospital, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|February 1, 1997
PubMed
Summary

Intracranial carotid artery aneurysms can cause pituitary dysfunction and severe hyperprolactinemia. Prompt diagnosis and surgical repair of the aneurysm can lead to reversible pituitary function and normalized prolactin levels.

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Area of Science:

  • Neuroendocrinology
  • Vascular Neurosurgery

Background:

  • Pituitary dysfunction secondary to intracranial aneurysms is uncommon.
  • This case highlights significant hyperprolactinemia mimicking a prolactin-secreting tumor.

Observation:

  • A 42-year-old woman presented with galactorrhea, headache, and visual field defects.
  • Imaging revealed a left internal carotid artery aneurysm compressing the pituitary region.
  • Elevated serum prolactin levels (365 micrograms/L) were noted.

Findings:

  • Surgical repair of the carotid artery aneurysm resulted in normalization of vision and prolactin levels.
  • Computed tomography (CT) and follow-up scans excluded pituitary adenoma.
  • The patient experienced complete recovery of pituitary function.

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Implications:

  • Marked hyperprolactinemia warrants consideration of vascular causes like carotid aneurysms.
  • Angiography or MRI is crucial to rule out aneurysms before pituitary surgery.
  • Carotid aneurysms can present as a treatable cause of reversible pituitary dysfunction.