title: Cushing's disease associated with unruptured large internal carotid artery aneurysm. Case report.
abstract: A 40-year-old woman with Cushing's disease presented with hypertensive cerebral hemorrhage. Neuroimaging detected an unruptured large intracavernous aneurysm, which projected beyond the midline, and thin crescent-shaped adenoma along the aneurysm wall. The aneurysm was treated with endovascular tight packing with coils. Transsphenoidal adenomectomy was then safely performed. The signs of Cushing's disease were resolved, and she was discharged without deficits. The first line therapy for Cushing's disease is transsphenoidal adenomectomy. However, the therapeutic strategy and optimal timing of treatment are unclear for Cushing's disease with large intracavernous aneurysm. The present case shows that transsphenoidal surgery was safely possible with minimal invasiveness after embolization of the intracavernous aneurysm.
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nishijima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sato
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000150:complications / Q000473:pathology* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D003480:Cushing Syndrome / Q000150:complications*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000473:pathology / Q000601:surgery; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000150:complications / Q000473:pathology* / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods