title: Intracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection.
abstract: We report a case of a 39-year-old man who presented with a nonfunctioning pituitary macroadenoma which extended into the suprasellar region. He underwent a transcranial resection of the tumor followed eight months later by transsphenoidal surgery for the residual tumor. Postoperatively he developed massive subarachnoid and intraventricular hemorrhage. A cerebral angiogram revealed a leaking anterior communicating artery aneurysm which was not seen on the computed tomography angiography and magnetic resonance angiography before the surgery. Complications of transsphenoidal surgery, particularly vascular hemorrhagic complications, and risk of rupture of undetected aneurysms are discussed.
authors: Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06032, USA. trustagi@resident.uchc.edu
authors: Tarun
authors: T
authors: Rustagi
authors: Edilfavia Mae
authors: EM
authors: Uy
authors: Mridula
authors: M
authors: Rai
authors: Subramanian
authors: S
authors: Kannan
authors: Patrick
authors: P
authors: Senatus
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications*; D002533:Cerebral Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018365:Neoplasm, Residual; D018458:Persistent Vegetative State / Q000209:etiology; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*