Fatal epistaxis from the fetal posterior communicating artery--a delayed complication of trans-sphenoidal surgery.
Vascular complications following trans-sphenoidal surgery can occur due to injury of the cavernous segment of the internal carotid artery, external carotid artery and its branches or an aneurysm rupture. The incidence of vascular complications in trans-sphenoidal surgery is 0.4% to 1.4%. Vascular injury was encountered in a patient with giant pituitary adenoma who underwent staged trans-sphenoidal tumour removal. Following his third surgery, he had delayed fatal epistaxis. An angiogram revealed a fetal type posterior communicating artery with a blow out of the junction of the posterior communicating artery with the posterior cerebral artery. The diagnosis and management of this condition are discussed.
Jagetia
Anita
A
Department of Neurosurgery, Govind Ballabh Pant Hospital and Maulana Azad Medical College, L. Nehru Marg, New Delhi, Delhi 110002, India. anitajagetia@gmail.com <anitajagetia@gmail.com>
Rajan
Sanjay
S
Sinha
Sanjiv
S
Singh
Daljit
D
D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000601:surgery*; D004844:Epistaxis / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*