Ono Hideaki, Inoue Tomohiro, Kunii Naoto, Tanishima Takeo, Tamura Akira, Saito Isamu, Saito Nobuhito
Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya, Shizuoka, Japan.
Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan.
Surg Neurol Int. 2017 Aug 9;8:180. doi: 10.4103/sni.sni_178_17. eCollection 2017.
Giant internal carotid artery (ICA) aneurysms extending into the sellar region, mimicking pituitary tumors, and causing pituitary dysfunction are relatively rare. Open surgery or endovascular treatment can treat these aneurysms, but achieving recovery of endocrine function is difficult.
A 56-year-old man presented with giant aneurysm of the ICA causing pituitary impairment, leading to disturbance of consciousness due to hyponatremia. High-flow bypass from the cervical external carotid artery to the middle cerebral artery and ligation of the ICA at the cervical portion were performed. One year after the operation, his pituitary function recovered well; he was followed up as an outpatient without hormonal replacement therapy for 8 years after the operation.
Giant ICA aneurysm causing pituitary dysfunction is relatively rare, but it is important to consider in the differential diagnosis for hypopituitarism. Treatment with high-flow bypass using radial artery graft can achieve both prevention of aneurysm rupture and recovery of pituitary function.
巨大的颈内动脉（ICA）动脉瘤延伸至鞍区，酷似垂体瘤并导致垂体功能障碍，这种情况相对罕见。开放手术或血管内治疗可用于治疗这些动脉瘤，但实现内分泌功能恢复却很困难。
一名56岁男性，患有导致垂体损害的颈内动脉巨大动脉瘤，因低钠血症导致意识障碍。进行了从颈外动脉到大脑中动脉的高流量搭桥术以及在颈部结扎颈内动脉。术后一年，他的垂体功能恢复良好；术后作为门诊患者随访8年，未进行激素替代治疗。
导致垂体功能障碍的巨大颈内动脉动脉瘤相对罕见，但在垂体功能减退的鉴别诊断中应予以考虑。使用桡动脉移植物进行高流量搭桥治疗既能预防动脉瘤破裂，又能恢复垂体功能。
