Matsuno A, Yoshida S, Basugi N, Itoh S, Tanaka J
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Surg Neurol. 1993 Apr;39(4):276-8. doi: 10.1016/0090-3019(93)90004-k.
There are many reports about complications of transphenoidal surgery for pituitary adenomas. We report a patient who suffered severe subarachnoid hemorrhage due to an indirect injury of the intradural internal carotid artery during or immediately after transsphenoidal surgery for pituitary adenoma. An autopsy suggested that a small branch of the intradural internal carotid artery was strongly adherent to the suprasellar portion of the tumor capsule and its avulsion from the internal carotid artery might have been caused as the capsule fell down during the intracapsular removal of the tumor. In a case of pituitary adenoma operated by the transsphenoidal approach the possibility of subarachnoid hemorrhage due to this type of arterial injury, though rare, should be kept in mind.
关于垂体腺瘤经蝶窦手术的并发症已有许多报道。我们报告一例患者，在垂体腺瘤经蝶窦手术期间或术后即刻，因硬脑膜内颈内动脉间接损伤而发生严重蛛网膜下腔出血。尸检提示，硬脑膜内颈内动脉的一个小分支与肿瘤包膜的鞍上部分紧密粘连，在肿瘤囊内切除过程中，随着包膜下落，可能导致该分支从颈内动脉撕脱。对于经蝶窦入路手术的垂体腺瘤病例，应牢记这种动脉损伤导致蛛网膜下腔出血的可能性，尽管这种情况罕见。
