Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics

Abstract

Aneurysms with intrasellar extension typically present due to mass effect on surrounding structures, and they can be classified as infradiaphragmatic cavernous or clinoid segment ICA aneurysms, or supradiaphragmatic ophthalmic ICA or anterior communicating artery aneurysms. Varying approaches exist for treating these complex aneurysms, and intervention strategies depend substantially on the anatomical subtype.

Expanded endonasal endoscopic approach for resection of a growth hormone-secreting pituitary macroadenoma coexistent with a cavernous carotid artery aneurysm

“…3 Such circumstances represent significant risk to the patient. In this report, we describe a patient who presented with a large sellar mass that extended into the right cavernous sinus and sphenoid sinus.…”

“…1 Since this initial description, there have been numerous similar reports which have been recently reviewed. 2,3 In a large retrospective study of 467 patients with PA, Pant et al reported no association between intracranial aneurysms and PA suggesting this occurrence is merely due to chance and the risk is no greater than among the general population. 4 However, Manara et al reported that acromegaly carries an increased risk of intracranial aneurysms with a prevalence of 17.3%.…”

Evaluation of the Sellar and Parasellar Regions

“…20 Aneurysms are usually off-midline, partially calcified (particularly the rim) on CT and have a flow-void AE mural thrombus on MR imaging. Even a completely thrombosed aneurysm should not expand the sella turcica or follow the imaging characteristics of a macroadenoma.…”

The Microscopic Transsphenoidal Approach for Craniopharyngiomas

“…Pulsatile flow may occasionally be transmitted in the midline position through a cystic mass from the basilar artery. This should be distinguished from vascular pathologies, such as an aneurysm, which may pose as a rare mimic for a sellar mass (Hanak et al, 2012).…”