Posterior Cerebral Artery Pseudoaneurysm, a Rare Complication of Pituitary Tumor Transsphenoidal Surgery

Case Report and Literature Review

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cerebrospinal fistula, meningitis, neural component injury, and vascular injury, may occur. One of the most common and severe complications is carotid artery injury; however, only 2 posterior cerebral artery injuries with pseudoaneurysm formation have been reported previously. One of them received bypass surgery and recovered well, but the other received endovascular treatment and died of intracranial hypertension. Herein, we report a rare case of iatrogenic pseudoaneurysm formation with hemorrhage after transsphenoidal surgery, in which tumor traction-related adjacent vessel injury was most likely. Aneurysm clipping, vascular bypass, and embolization are considered reasonable choices depending on the patient's condition for iatrogenic aneurysm formation. In our case, no surgical or endovascular intervention was performed, and the aneurysm healed spontaneously 3 weeks later.

Original languageEnglish
Pages (from-to)1493E1-1493E3
JournalWorld Neurosurgery
Volume84
Issue number5
DOIs
Publication statusPublished - Nov 1 2015

Fingerprint

Posterior Cerebral Artery
False Aneurysm
Pituitary Neoplasms
Aneurysm
Wounds and Injuries
Carotid Artery Injuries
Intracranial Hypertension
Vascular System Injuries
Traction
Pituitary Gland
Meningitis
Fistula
Blood Vessels
Hemorrhage
Mortality
Therapeutics
Neoplasms

Keywords

  • Iatrogenic
  • Pituitary adenoma
  • Posterior cerebral artery aneurysm
  • Pseudoaneurysm
  • Transsphenoidal surgery
  • Vascular injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

@article{4b6f7ccf803d4d1fb889f2d8faa8a023,
title = "Posterior Cerebral Artery Pseudoaneurysm, a Rare Complication of Pituitary Tumor Transsphenoidal Surgery: Case Report and Literature Review",
abstract = "Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cerebrospinal fistula, meningitis, neural component injury, and vascular injury, may occur. One of the most common and severe complications is carotid artery injury; however, only 2 posterior cerebral artery injuries with pseudoaneurysm formation have been reported previously. One of them received bypass surgery and recovered well, but the other received endovascular treatment and died of intracranial hypertension. Herein, we report a rare case of iatrogenic pseudoaneurysm formation with hemorrhage after transsphenoidal surgery, in which tumor traction-related adjacent vessel injury was most likely. Aneurysm clipping, vascular bypass, and embolization are considered reasonable choices depending on the patient's condition for iatrogenic aneurysm formation. In our case, no surgical or endovascular intervention was performed, and the aneurysm healed spontaneously 3 weeks later.",
keywords = "Iatrogenic, Pituitary adenoma, Posterior cerebral artery aneurysm, Pseudoaneurysm, Transsphenoidal surgery, Vascular injury",
author = "Lee, {Chih Hsun} and Chen, {Shu Mei} and Lui, {Tai Ngar}",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.wneu.2015.04.043",
language = "English",
volume = "84",
pages = "1493E1--1493E3",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Posterior Cerebral Artery Pseudoaneurysm, a Rare Complication of Pituitary Tumor Transsphenoidal Surgery

T2 - Case Report and Literature Review

AU - Lee, Chih Hsun

AU - Chen, Shu Mei

AU - Lui, Tai Ngar

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cerebrospinal fistula, meningitis, neural component injury, and vascular injury, may occur. One of the most common and severe complications is carotid artery injury; however, only 2 posterior cerebral artery injuries with pseudoaneurysm formation have been reported previously. One of them received bypass surgery and recovered well, but the other received endovascular treatment and died of intracranial hypertension. Herein, we report a rare case of iatrogenic pseudoaneurysm formation with hemorrhage after transsphenoidal surgery, in which tumor traction-related adjacent vessel injury was most likely. Aneurysm clipping, vascular bypass, and embolization are considered reasonable choices depending on the patient's condition for iatrogenic aneurysm formation. In our case, no surgical or endovascular intervention was performed, and the aneurysm healed spontaneously 3 weeks later.

AB - Endoscopic endonasal transsphenoidal surgery for pituitary tumors has been the standard therapy for decades. This approach offers surgeons an effective, safe, and wide exposure to the pituitary gland, with a relatively low mortality rate and acceptable complication rates. However, severe complications, including cerebrospinal fistula, meningitis, neural component injury, and vascular injury, may occur. One of the most common and severe complications is carotid artery injury; however, only 2 posterior cerebral artery injuries with pseudoaneurysm formation have been reported previously. One of them received bypass surgery and recovered well, but the other received endovascular treatment and died of intracranial hypertension. Herein, we report a rare case of iatrogenic pseudoaneurysm formation with hemorrhage after transsphenoidal surgery, in which tumor traction-related adjacent vessel injury was most likely. Aneurysm clipping, vascular bypass, and embolization are considered reasonable choices depending on the patient's condition for iatrogenic aneurysm formation. In our case, no surgical or endovascular intervention was performed, and the aneurysm healed spontaneously 3 weeks later.

KW - Iatrogenic

KW - Pituitary adenoma

KW - Posterior cerebral artery aneurysm

KW - Pseudoaneurysm

KW - Transsphenoidal surgery

KW - Vascular injury

UR - http://www.scopus.com/inward/record.url?scp=84947022177&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947022177&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2015.04.043

DO - 10.1016/j.wneu.2015.04.043

M3 - Article

VL - 84

SP - 1493E1-1493E3

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 5

ER -