Embolization of the meningohypophyseal trunk as a cause of diabetes insipidus.
We present an unusual case of diabetes insipidus occurring after selective embolization of 50% dextrose and pure ethanol into an enlarged left meningohypophyseal trunk (MHT) supplying a dural carotid cavernous fistula. The inferior hypophyseal artery was not opacified during the selective preembolization MHT injection; however, diabetes insipidus developed abruptly a few hours after the procedure. The patient required intranasal 1-deamino-(8-D-arginine)-vasopressin for approximately 3 months, after which his symptoms resolved. The hazards of using liquid embolic agents, especially ethanol, in the cavernous branches of the internal carotid artery should always be borne in mind.
Phatouros
C C
CC
Division of Neurointerventional Radiology, University of California at San Francisco Medical Center, 94143, USA.
Higashida
R T
RT
Malek
A M
AM
Smith
W S
WS
Dowd
C F
CF
Halbach
V V
VV
D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D002426:Cavernous Sinus / Q000002:abnormalities; D002533:Cerebral Angiography; D003919:Diabetes Insipidus / Q000209:etiology*; D004388:Dura Mater / Q000098:blood supply; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008578:Meninges / Q000098:blood supply* / Q000000981:diagnostic imaging; D008875:Middle Aged; D010902:Pituitary Gland / Q000098:blood supply* / Q000000981:diagnostic imaging