Fatal epistaxis from the fetal posterior communicating artery – a delayed complication of trans-sphenoidal surgery

Jagetia, Anita; Rajan, Sanjay; Sinha, Shalini; Singh, Daljit

doi:10.1016/j.jocn.2009.09.010

Cited by 5 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6,7 Carotid injuries are more likely to occur in patients with previous transsphenoidal surgery or radiation therapy, invasive adenomas, endoscopic surgery, anatomical variations such as bulging of ICA into the sphenoid sinus or covered only by the dura mater of the cavernous sinus and the mucosa of the sphenoid sinus without bony covering. 8,9 In the present case, the tumor was not very large, and the probable cause of injury would have been a deviation from midline reaching more toward the right side of the sella.…”

Section: Discussionmentioning

confidence: 51%

Treatment Dilemma of Latrogenic Pseudoaneurysm of the Intracavernous Internal Carotid Artery in Young Girl Following Transnasal Transsphenoidal Surgery: A Case Report

et al. 2022

Self Cite

View full text Add to dashboard Cite

Epistaxis following transnasal transsphenoidal (TNTS) removal of pituitary adenoma can be massive and life-threatening. The intracranial source of bleeding is usually the intracavernous segment of the internal carotid artery (ICA) or adjacent branches. Injury to the cavernous ICA can lead to pseudoaneurysm (PA) or fistula formation. Management of PA is different from saccular aneurysms. A timely diagnosis and adequate management can restore vessel integrity and prevent associated morbidity. A young patient of growth hormone-secreting pituitary adenoma, who underwent microscopic TNTS excision of the tumour, presented with massive epistaxis. Pseudoaneurysm of the cavernous ICA was initially not seen on computed tomography angiography and was later diagnosed on digital subtraction angiography. The attempted management of PA with coils without stent could not stop aneurysm recurrence. The management of such complicated PAs is discussed, and a literature review is done regarding epistaxis in growth hormone secreting adenoma.

show abstract

Section: Discussionmentioning

confidence: 51%

Treatment Dilemma of Latrogenic Pseudoaneurysm of the Intracavernous Internal Carotid Artery in Young Girl Following Transnasal Transsphenoidal Surgery: A Case Report

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The fetal-type PComA has also shown difficulties in open surgery. Inadvertent injury to the fetal-type PComA during transsphenoidal surgery has been reported and can lead to severe, uncontrollable epistaxis due to the continued filling from the basilar artery [5]. It is also important to note that PComA aneurysms are properly defined as ICA-PComA aneurysms, in that they arise from the origin of the PComA at its branch point from the ICA [6].…”

Section: Discussionmentioning

confidence: 99%

A Fetal-type Variant Posterior Communicating Artery and its Clinical Significance

Capone

Shah

Bernard

2019

Cureus

View full text Add to dashboard Cite

The fetal posterior communicating artery is a well-established variant of the cerebral vasculature, occurring in 4-29% of the population. This variant can provide unique challenges in the identification and treatment of cerebrovascular disease or a cerebrovascular accident. Here we present a cadaveric case showing the presence of the fetal-type posterior communicating artery with a contralateral calcified internal carotid artery and discuss the importance of understanding this embryological variant. This case provides specific and unique clinical sequelae that require treatment to be initiated while understanding the various complications that may arise.

show abstract

“…Complication rate of vascular injury during transsphenoidal surgery for pituitary adenoma is reported as approximately 1%10). Injury of internal carotid artery (ICA) during transsphenoidal surgery of pituitary adenoma may result in catastrophic situation including death.…”

Section: Discussionmentioning

confidence: 99%

Large Intracranial Aneurysm after Transsphenoidal Surgery for Pituitary Macroadenoma

Yoon

Cho

Lee

2014

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Uncontrolled cerebrospinal fluid (CSF) leakage after transsphenoidal surgery (TSS) for pituitary adenoma can lead to meningitis. Intracranial mycotic pseudoaneurysm is a rare complication in central nervous system infection. Large single pseudoaneurysm is more uncommon. Most mycotic aneurysms occur due to endocarditis. The present patient had no heart problem and was infected by CSF leakage after transsphenoidal surgery. We present a case of large ruptured mycotic pseudoaneurysm as a complication of cerebral infection after TSS for pituitary macroadenoma.

show abstract

Fatal epistaxis from the fetal posterior communicating artery – a delayed complication of trans-sphenoidal surgery

Cited by 5 publications

References 6 publications

Treatment Dilemma of Latrogenic Pseudoaneurysm of the Intracavernous Internal Carotid Artery in Young Girl Following Transnasal Transsphenoidal Surgery: A Case Report

Treatment Dilemma of Latrogenic Pseudoaneurysm of the Intracavernous Internal Carotid Artery in Young Girl Following Transnasal Transsphenoidal Surgery: A Case Report

A Fetal-type Variant Posterior Communicating Artery and its Clinical Significance

Large Intracranial Aneurysm after Transsphenoidal Surgery for Pituitary Macroadenoma

Contact Info

Product

Resources

About