Endoscopic approach to cavernous sinus aneurysm

Abstract

Aneurysms protruding into sellae may mimic pituitary tumors by compressing adjacent cranial nerves. Carotid-Cavernous aneurysms are rarely associated with mortality, and surgical intervention is recommended especially for neuro-ophthalmologic progression. In this report we presented a 51-year-old woman who had severe headache and neuro-ophthalmologic signs with the initial diagnosis of pituitary apoplexy on MRI (Magnetic Resonanse Imaging). However preoperative CTA (Computed Tomography Angiography) revealed a carotid cavernous aneurysm protruding into sellae. The patient underwent endovascular intervention and endoscopic transphenoidal approach for the removal of the hematoma compressing the cranial nerves. The patient's neuro-ophthalmologic symptoms were improved during the follow-up, which may be related due to rapid evacuation of the hematoma.