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垂体大腺瘤合并鞍上颈内动脉脑动脉瘤:一例报告并文献复习

Pituitary macroadenoma co-existent with supraclinoid internal carotid artery cerebral aneurysm: a case report and review of the literature.

作者信息

Wang Chia-Sheng, Yeh Tsung-Chih, Wu Tai-Ching, Yeh Chao-Hung

机构信息

Department of Neurosurgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan, Taiwan.

出版信息

Cases J. 2009 Jul 23;2:6459. doi: 10.4076/1757-1626-2-6459.

Abstract

With improved angiographic techniques and magnetic resonance angiography available today, an increasing number of incidental aneurysms are being detected. Occurrence of an intracranial aneurysm together with a pituitary adenoma presents tremendous risk to the patient, particularly when the aneurysm lies near the operative field.A 61-year-old woman presented with a progressive visual field defect. Neurological examination revealed bi-temporal haemianopia. Cerebral magnetic resonance imaging and angiography revealed a pituitary macroadenoma co-existent with a cerebral aneurysm near the sellar region. The patient underwent an endovascular procedure for aneurysm embolisation and then underwent surgery for removal of the pituitary adenoma via a trans-sphenoidal approach.We report our experience and emphasize the need for critical evaluation of neuroradiological examinations for precise diagnosis for avoiding a possible life-threatening situation.

摘要

随着如今血管造影技术和磁共振血管造影的改进,越来越多的偶然发现的动脉瘤被检测出来。颅内动脉瘤与垂体腺瘤同时出现给患者带来了巨大风险,尤其是当动脉瘤位于手术区域附近时。一名61岁女性出现进行性视野缺损。神经系统检查发现双颞侧偏盲。脑磁共振成像和血管造影显示鞍区附近存在垂体大腺瘤与脑动脉瘤并存。患者先接受了动脉瘤栓塞的血管内手术,然后通过经蝶窦入路接受了垂体腺瘤切除术。我们报告我们的经验,并强调需要对神经放射学检查进行严格评估以进行精确诊断,从而避免可能危及生命的情况。

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