Abstract:
BACKGROUND:Intracranial pseudoaneurysm is a rare complication of endoscopic endonasal surgery. Herein, we describe 2-staged stent-assisted coil embolization for posterior communicating artery pseudoaneurysm after endoscopic endonasal surgery for pituitary adenoma. CASE DESCRIPTION:A 68-year-old man had a history of severe adult growth hormone secretion deficiency, requiring growth hormone replacement therapy; secondary adrenocortical hypofunction; hyperthyroidism; hypertension; constipation; glaucoma; and hyperuricemia. Five years ago, after initial endoscopic transsphenoidal surgery for pituitary adenoma, he was hospitalized for reoperation. Posterior communicating artery injury was observed during second endoscopic transsphenoidal surgery, and pressure hemostasis was performed using a hemostatic preparation. Immediately post surgery, a localized subarachnoid hemorrhage was observed. Sudden-onset impaired consciousness and respiratory disturbances ensued on postoperative day 7, and computed tomography of the head was performed. Recurrent subarachnoid hemorrhage was confirmed, and acute hydrocephalus secondary to third ventricular blockage was identified. Cerebral angiography was performed after urgent bilateral cerebral ventricular drainage under general anesthesia. A pseudoaneurysm was identified in the left posterior communicating artery, and coil embolization was performed. Six weeks post surgery, a low-profile visualized intraluminal stent called an LVIS Jr. stent was placed in the posterior communicating artery. Recurrence of the aneurysm was not detected 6 months post surgery. He underwent lumboperitoneal shunting for secondary normal pressure hydrocephalus after dual antiplatelet therapy discontinuation and is being followed up as an outpatient with a modified Rankin scale score of 2 ten months post surgery. CONCLUSIONS:Two-staged stent-assisted coil embolization using a low-profile visualized intraluminal stent was effective for a posterior communicating artery pseudoaneurysm occurring after posterior communicating artery injury following endoscopic transsphenoidal surgery for follicle-stimulating hormone-producing pituitary adenoma.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Morinaga Y,Nii K,Sakamoto K,Inoue R,Mitsutake T,Hanada Hdoi
10.1016/j.wneu.2018.12.047subject
Has Abstractpub_date
2019-03-01 00:00:00pages
301-305eissn
1878-8750issn
1878-8769pii
S1878-8750(18)32870-5journal_volume
123pub_type
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.120
更新日期:2017-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.023
更新日期:2017-09-01 00:00:00
abstract::Dorsal arachnoid web (DAW) is a rare clinical entity with unknown etiology, and it can mimic other conditions on imaging.1,2 We present a surgical video of a patient with DAW that was misdiagnosed as ventral cord herniation. A 35-year-old woman presented with upper back pain and progressive bilateral lower extremity w...
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2019.07.213
更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2019.12.121
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journal_title:World neurosurgery
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2011.02.021
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.121
更新日期:2018-05-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2017-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.04.100
更新日期:2020-07-01 00:00:00
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2020.08.084
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.08.019
更新日期:2014-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.11.038
更新日期:2020-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.174
更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2016-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.049
更新日期:2020-11-01 00:00:00
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journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.132
更新日期:2021-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2012-02-01 00:00:00
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更新日期:2019-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2018-05-01 00:00:00
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更新日期:2019-09-01 00:00:00
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