title: Spontaneous subarachnoid haemorrhage from rupture of an anterior communicating artery aneurysm in a patient with pituitary macroadenoma.
abstract: The presence of a cerebral aneurysm in patients with pituitary adenoma is a rare event. Diagnostic suspicion may stem from magnetic resonance imaging, which should lead to complementary investigation. As for treatment, even in conditions in which there has been no previous bleeding, the simultaneous approach should be considered, prioritising the aneurysm most of the time. The present report describes the case of a patient with a history of pituitary macroadenoma, who had undergone a partial transsphenoidal resection ten years earlier. Admission to our service occurred after a sudden headache followed by mental confusion. A cranial computed tomography showed subarachnoid haemorrhage and expansive suprasellar lesion. Cerebral angiography showed a saccular aneurysm of the anterior communicating complex. The patient underwent a surgical procedure for microsurgical clipping of the aneurysm and partial resection of the pituitary tumour. We have also included a brief review of the literature on this subject.
authors.affiliation: Division of Neurosurgery, Santa Marcelina de Itaquaquecetuba Hospital, São Paulo, Brazil.
authors.forename: J M
authors.initials: JM
authors.lastname: Almeida Silva
authors.affiliation: Division of Neurosurgery, Santa Marcelina de Itaquaquecetuba Hospital, São Paulo, Brazil.
authors.forename: R R
authors.initials: RR
authors.lastname: Campos
authors.affiliation: Division of Neurosurgery, Santa Marcelina de Itaquaquecetuba Hospital, São Paulo, Brazil.
authors.forename: R R
authors.initials: RR
authors.lastname: Souza
authors.affiliation: Division of Neurosurgery, Santa Marcelina de Itaquaquecetuba Hospital, São Paulo, Brazil.
authors.forename: M E
authors.initials: ME
authors.lastname: Sette Dos Santos
authors.affiliation: Division of Neurosurgery, Santa Marcelina de Itaquaquecetuba Hospital, São Paulo, Brazil. Electronic address: guilhermebraguiar@yahoo.com.br.
authors.forename: G B
authors.initials: GB
authors.lastname: Aguiar
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001766:Blindness / Q000209:etiology; D003221:Confusion / Q000209:etiology; D051270:Headache Disorders, Primary / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D012422:Rupture, Spontaneous; D013314:Stress, Mechanical; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed
keywords: Aneurisma intracraneal; Angiografía cerebral; Cerebral angiography; Hemorragia subaracnoidea; Hipófisis; Intracranial aneurysm; Pituitary gland; Pituitary neoplasms; Subarachnoid haemorrhage; Tumor de hipofisís