Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm
The presence of an intracranial aneurysm together with a pituitary adenoma presents tremendous risk of subarachnoid hemorrhage, during transsphenoidal surgery, particularly when the aneurysm lies near the operative field. A left supraclinoid internal carotid artery aneurysm and a clinically nonfunct...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/891847 |
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| author | So Yamada Shoko M. Yamada Toshio Hirohata Yudo Ishii Katsumi Hoya Mineko Murakami Akira Matsuno |
| author_facet | So Yamada Shoko M. Yamada Toshio Hirohata Yudo Ishii Katsumi Hoya Mineko Murakami Akira Matsuno |
| author_sort | So Yamada |
| collection | DOAJ |
| description | The presence of an intracranial aneurysm together with a pituitary adenoma presents tremendous risk of subarachnoid hemorrhage, during transsphenoidal surgery, particularly when the aneurysm lies near the operative field. A left supraclinoid internal carotid artery aneurysm and a clinically nonfunctioning pituitary adenoma coexisted in a 57-year-old woman. Initially, the aneurysm was treated by endovascular coil placement, and then the patient underwent pseudocapsule-based extracapsular resection of the pituitary tumor via a transnasal transsphenoidal endoscopic approach. Pseudocapsule-based extracapsular total resection was safely performed, because of the extirpated risk of rupture of the coil-treated aneurysm. Recently, transsphenoidal pseudocapsule-based extracapsular resection approach for pituitary adenomas provides a more effective and safe alternative compared to the traditional intracapsular one because of its higher tumor removal and remission rates and lower recurrence rate. Compared with conventional subcapsular removal, pseudocapsule-based extracapsular resection has more risks of aneurysmal rupture that is located adjacent to pituitary adenoma. Thus, in a patient having a cerebral aneurysm with the proximity to the operative field, the cerebral aneurysm should be first treated with endovascular coil placement or direct surgical procedure; subsequently, pseudocapsule-based extracapsular resection of the pituitary tumor via a transnasal transsphenoidal endoscopic approach should be performed. |
| format | Article |
| id | doaj-art-9b33a8775aba4c6e9bf2962380eba39d |
| institution | OA Journals |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-9b33a8775aba4c6e9bf2962380eba39d2025-08-20T02:20:26ZengWileyCase Reports in Neurological Medicine2090-66682090-66762012-01-01201210.1155/2012/891847891847Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery AneurysmSo Yamada0Shoko M. Yamada1Toshio Hirohata2Yudo Ishii3Katsumi Hoya4Mineko Murakami5Akira Matsuno6Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanDepartment of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanDepartment of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanDepartment of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, JapanDepartment of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanDepartment of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanDepartment of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba 299-0111, JapanThe presence of an intracranial aneurysm together with a pituitary adenoma presents tremendous risk of subarachnoid hemorrhage, during transsphenoidal surgery, particularly when the aneurysm lies near the operative field. A left supraclinoid internal carotid artery aneurysm and a clinically nonfunctioning pituitary adenoma coexisted in a 57-year-old woman. Initially, the aneurysm was treated by endovascular coil placement, and then the patient underwent pseudocapsule-based extracapsular resection of the pituitary tumor via a transnasal transsphenoidal endoscopic approach. Pseudocapsule-based extracapsular total resection was safely performed, because of the extirpated risk of rupture of the coil-treated aneurysm. Recently, transsphenoidal pseudocapsule-based extracapsular resection approach for pituitary adenomas provides a more effective and safe alternative compared to the traditional intracapsular one because of its higher tumor removal and remission rates and lower recurrence rate. Compared with conventional subcapsular removal, pseudocapsule-based extracapsular resection has more risks of aneurysmal rupture that is located adjacent to pituitary adenoma. Thus, in a patient having a cerebral aneurysm with the proximity to the operative field, the cerebral aneurysm should be first treated with endovascular coil placement or direct surgical procedure; subsequently, pseudocapsule-based extracapsular resection of the pituitary tumor via a transnasal transsphenoidal endoscopic approach should be performed.http://dx.doi.org/10.1155/2012/891847 |
| spellingShingle | So Yamada Shoko M. Yamada Toshio Hirohata Yudo Ishii Katsumi Hoya Mineko Murakami Akira Matsuno Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm Case Reports in Neurological Medicine |
| title | Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm |
| title_full | Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm |
| title_fullStr | Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm |
| title_full_unstemmed | Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm |
| title_short | Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm |
| title_sort | endoscopic extracapsular removal of pituitary adenoma the importance of pretreatment of an adjacent unruptured internal carotid artery aneurysm |
| url | http://dx.doi.org/10.1155/2012/891847 |
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