Abstract
Objective To summarize the imaging findings, treatment and prognosis of pituitary adenoma associated with intracranial aneurysm. Methods From July 2014 to June 2017, 4 patients (3 females and 1 male) with pituitary macroadenoma associated with intracranial aneurysm were admitted to Neurosurgery Department of the Second Affiliated Hospital of Zhejiang University School of Medicine. Among them, 1 patient had bilateral ophthalmic artery aneurysms and 2 cases had right ophthalmic artery aneurysms. All those 3 cases underwent endovascular treatment of intracranial aneurysms followed by transsphenoidal surgery for pituitary adenomas. The other 1 patient with anterior communicating artery aneurysm underwent successful clipping of aneurysm after removal of pituitary adenoma. Results Of the 4 patients with pituitary adenoma and intracranial aneurysm, 3 underwent endovascular embolization of the aneurysm followed by endoscopic transsphenoidal pituitary adenoma resection. MRI showed no recurrence after resection. Digital subtraction angiography (DSA) was performed and revealed that the aneurysm had no recurrence and a good prognosis. One patient with anterior communicating artery aneurysm, although undergoing aneurysm clipping and pituitary adenoma resection, eventually gave up treatment due to pulmonary infection, resulting in a poor prognosis. Conclusions For patients with pituitary adenoma with high risk factors, it is recommended to perform magnetic resonance angiography (MRA) and/or DSA before surgery. MRI T1 and T2 weighted sequences showing flow shadow is an important factor for pituitary adenoma with intracranial aneurysms. For patients with pituitary adenomas with intracranial aneurysms, one or two stages of surgery should be performed according to the presence or absence of aneurysm, and a relatively good prognosis can be obtained. Key words: Pituitary neoplasms; Intracranial aneurysm; Diagnosis; Treatment; Prognosis
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