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(Stroke. 2001;32:567.)
© 2001 American Heart Association, Inc.

Case Reports

Pituitary Apoplexy Caused by Ruptured Internal Carotid Artery Aneurysm

Hidenori Suzuki, MD; Masatoshi Muramatsu, MD; Kenichi Murao, MD; Kenji Kawaguchi, MD Takeo Shimizu, MD

From the Department of Neurosurgery, Mie Prefectural General Medical Center (H.S., M.M., T.S.) and Mie University School of Medicine (K.M., K.K.), Mie, Japan.

Correspondence to Hidenori Suzuki, MD, Department of Neurosurgery, Mie Prefectural General Medical Center, 5450-132 Hinaga, Yokkaichi, Mie 510-0885, Japan. E-mail miegmc1{at}wj8.so-net.ne.jp

Abstract

Background and Purpose—We report the first case of pituitary apoplexy caused by the rupture of an intracavernous carotid artery aneurysm embedded in a pituitary adenoma.

Case Description—A 46-year-old man presented with clinical and CT findings typical of pituitary apoplexy. MRI showed an unusual flow-void protrusion into the intratumoral hematoma, which, however, was not diagnosed as a ruptured aneurysm until severe intraoperative bleeding occurred. Angiography after surgery revealed an intracavernous carotid artery aneurysm.

Conclusions—The possible association of adenoma and aneurysmal rupture should be kept in mind when assessing any case of pituitary apoplexy.

Key Words: adenoma • cerebral aneurysm • hematoma • pituitary apoplexy • pituitary neoplasms