Internal carotid artery false aneurysm as a fatal complication of transsphenoidal surgery
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Internal carotid artery false aneurysm as a fatal complication of transsphenoidal surgery. / Sumislawski, Piotr; Ludwig, Carolin; Rotermund, Roman; Grzyska, Ulrich; Flitsch, Jörg.
in: J SURG CASE REP, Jahrgang 2021, Nr. 4, 04.2021, S. rjab146.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Internal carotid artery false aneurysm as a fatal complication of transsphenoidal surgery
AU - Sumislawski, Piotr
AU - Ludwig, Carolin
AU - Rotermund, Roman
AU - Grzyska, Ulrich
AU - Flitsch, Jörg
N1 - Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2021.
PY - 2021/4
Y1 - 2021/4
N2 - False aneurysm of internal carotid artery (ICA) is a rare but serious vascular complication observed after transsphenoidal pituitary surgery. Here, we present a 41-year-old woman with a pseudoaneurysm in the ophthalmic1 segment of the left ICA after exoscopic transsphenoidal pituitary surgery. The initially uneventful procedure was complicated by a subarachnoidal hemorrhage 10 days after the surgery, which was confirmed by cranial computed tomography scan. The emergency angiography revealed a pseudoaneurysm of the ophthalmic1 part of the left ICA. Despite repeated endovascular treatments with a flow diverter and coiling, the patient experienced a re-bleeding with consecutive vasospasms, occlusion hydrocephalus and finally bifrontal intracerebral hemorrhage with fatal outcome. As a conclusion in irregular post-operative courses with for example headache, a post-operative magnetic resonance imaging with vessel presentation using TOF sequence and contrast-enhanced MRA might be recommended in order to detect a possible pseudoaneurysm in an early stage.
AB - False aneurysm of internal carotid artery (ICA) is a rare but serious vascular complication observed after transsphenoidal pituitary surgery. Here, we present a 41-year-old woman with a pseudoaneurysm in the ophthalmic1 segment of the left ICA after exoscopic transsphenoidal pituitary surgery. The initially uneventful procedure was complicated by a subarachnoidal hemorrhage 10 days after the surgery, which was confirmed by cranial computed tomography scan. The emergency angiography revealed a pseudoaneurysm of the ophthalmic1 part of the left ICA. Despite repeated endovascular treatments with a flow diverter and coiling, the patient experienced a re-bleeding with consecutive vasospasms, occlusion hydrocephalus and finally bifrontal intracerebral hemorrhage with fatal outcome. As a conclusion in irregular post-operative courses with for example headache, a post-operative magnetic resonance imaging with vessel presentation using TOF sequence and contrast-enhanced MRA might be recommended in order to detect a possible pseudoaneurysm in an early stage.
U2 - 10.1093/jscr/rjab146
DO - 10.1093/jscr/rjab146
M3 - SCORING: Journal article
C2 - 33927876
VL - 2021
SP - rjab146
JO - J SURG CASE REP
JF - J SURG CASE REP
SN - 2042-8812
IS - 4
ER -