Simultaneous Treatment of a Pituitary Adenoma and an Internal Carotid Artery Aneurysm Through a Supraorbital Keyhole Approach

Abstract

We describe a case in which an incidental left carotid aneurysm was found during the preoperative evaluation of a pituitary adenoma. After magnetic resonance imaging (MRI) and angiography delineated their characteristics, we chose to treat both lesions simultaneously through a left supraorbital keyhole approach. The aneurysm clipping was followed by intracapsular resection of the tumor that was identified later as a non-secretory adenoma. The postoperative course was uneventful. This case shows that in carefully selected patients it is possible to treat successfully concurrent conditions through a minimally invasive approach, with the well known advantages of low morbidity and a short hospital stay.

Craniotomy - Pituitary Neoplasms - Cerebral Aneurysm

References

• 1 Weir B. Pituitary tumors and aneurysms: case report and review of the literature.  Neurosurgery. 1992;  30 585-591
• 2 Jakubowski J, Kendall B. Coincedental aneurysms with tumours of pituitary origin.  J Neurol Neurosurg Psychiat. 1978;  41 972-979
• 3 Wakai S, Fukushima T, Furihata T, Sano K. Association of cerebral aneurysm with pituitary adenoma.  Surg Neurol. 1979;  12 503-507
• 4 Pant B, Arita K, Kurisu K, Tominaga A, Eguchi K, Uozumi T. Incidence of intracranial aneurysm associated with pituitary adenoma.  Neurosurg Rev. 1997;  20 13-17
• 5 van Lindert E, Perneczky A, Fries G, Pierangeli E. The supraorbital keyhole approach to supratentorial aneurysms: concept and technique.  Surg Neurol. 1998;  49 481-490
• 6 Hori T, Muraoka K, Hokama Y, Takami M, Saito Y. A growth-hormone-producing pituitary adenoma and an internal carotid aneurysm.  Surg Neurol. 1982;  18 108-111
• 7 Heiskanen O, Poranen A. Surgery of incidental intracranial aneurysms.  Surg Neurol. 1987;  28 432-436