Giant, thrombosed, sellar–suprasellar internal carotid artery aneurysm with persistent, primitive trigeminal artery causing hypopituitarism
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Arun Tungaria , Vijendra Kumar , Pallav Garg , Awadhesh K. Jaiswal , Sanjay Behari
- چاپ و سال / کشور: 2011
Description
A rare case of a giant, thrombosed, sellar– suprasellar paraclinoid internal carotid artery (ICA) aneurysm with persistent primitive trigeminal artery (PPTA) causing hypopituitarism that manifested as hypogonadism, hypothyroidism, and hypocortisolism is reported. There were no visual/neurological deficits, diabetes insipidus, or episodes of subarachnoid hemorrhage. The alteration in the flow dynamics of the circle of Willis due to the presence of PPTA may have been responsible for both the genesis of the giant aneurysm as well as for the induction of thrombogenesis within its lumen. As the digital subtraction angiogram showed complete thrombosis within the aneurysm and hormonal replacement therapy was effective in ensuring complete normalization of symptoms, the patient was unwilling to undergo surgical clipping of the aneurysm and removal of the suprasellar clot in an attempt to restore pituitary functions. Hypopituitarism recurred when the patient stopped her hormonal supplementation therapy after 7 years, and she again became symptom-free on restarting the therapy. To the best of the authors' knowledge, this represents the first reported case in the literature of hypopituitarism consequent to a giant, thrombosed, sellar– suprasellar ICA aneurysm with an associated PPTA on the side of the aneurysm.
Acta Neurochir (2011) 153:1129–1133 DOI 10.1007/s00701-010-0931-z Received: 21 July 2010 / Accepted: 24 December 2010 / Published online: 14 January 2011 # Springer-Verlag 2011
