title: A rare vascular complication of transsphenoidal surgery.
abstract: We report a rare case of anterior cerebral artery (ACA) thrombosis following transsphenoidal surgery in a case of growth hormone secreting pituitary macroadenoma. During the surgery, there was arachnoid breach with cerebrospinal fluid (CSF) leak. Post operatively, she became blind in both eyes for which re-exploration was done. A computed tomographic (CT) scan 16 hours after surgery showed a large tumor bed haematoma which was explored transcranially. During surgery, the right A1 was thrombosed while the ICA and middle cerebral artery (MCA) were patent as confirmed by post-operative magnetic resonance imaging (MRI). However, she died on the second post-operative day. ACA thrombosis following transsphenoidal surgery has not been reported before. A review of literature and possible mechanism of this complication has been discussed.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029, India. dibhat@rediffmail.com
authors.forename: D I
authors.initials: DI
authors.lastname: Bhat
authors.forename: G
authors.initials: G
authors.lastname: Jagatlal
authors.forename: B
authors.initials: B
authors.lastname: Indira Devi
mesh_terms: D000236:Adenoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D020771:Anterior Cerebral Artery; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications; D013101:Sphenoid Sinus / Q000601:surgery*; D055815:Young Adult