Suprasellar Aneurysm Research Articles

Arteriography with helicoidal scanner in the study of complex aneurysms of the circle of Willis

Computed tomography angiography (CTA) can add information to digital subtraction angiography (DSA) in selected cases of aneurysms of the circle of Willis. 1. Patient with progressive visual loss and headache. CT and DSA showed an image of partially thrombosed suprasellar aneurysm. CTA better defined the relationship between the lesion and regional vessels. 2. Woman with subarachnoid hemorrhage (SAH). CTA defined the aneurysmal neck and its relationship to the clinoid process. 3. Man with SAH, CT and DSA showed an arteriovenous malformation and three arterial aneurysms one of which was in a tortuous vessel. CTA confirmed digital angiographic data. CTA is a new image technique that can either add or confirm DSA findings in complex aneurysms of the circle of Willis.

Enlarging Thrombosed Aneurysm of the Distal Basilar Artery

Abstract The case of a 65-year-old man who had partial left third nerve palsy is reported. Radiographic examination disclosed a completely thrombosed giant suprasellar aneurysm. Although an angiogram appeared to indicate that his aneurysm arose from the distal basilar artery, he was also noted to have an unusual and ectatic distal internal carotid artery on the left side, and this was also felt to be a potential source of the aneurysm. Operative exploration was performed and confirmed the basilar artery as the sight of origin, and definitive therapy was deferred. The patient's progress was monitored, and for 3 years his neurological course was stable and there was no change in his radiographic abnormalities. During the 6 months following this period, the patient developed signs and symptoms of progressing hydrocephalus and was found to have significant enlargement of his still completely thrombosed giant aneurysm. This complicated case highlights the controversy regarding the management of this difficult condition, particularly with regard to endovascular therapies, and also provides insight into the evolution of this dynamic disease process.

Enlarging thrombosed aneurysm of the distal basilar artery

The case of a 65-year-old man who had partial left third nerve palsy is reported. Radiographic examination disclosed a completely thrombosed giant suprasellar aneurysm. Although an angiogram appeared to indicate that his aneurysm arose from the distal basilar artery, he was also noted to have an unusual and ectatic distal internal carotid artery on the left side, and this was also felt to be a potential source of the aneurysm. Operative exploration was performed and confirmed the basilar artery as the sight of origin, and definitive therapy was deferred. The patient's progress was monitored, and for 3 years his neurological course was stable and there was no change in his radiographic abnormalities. During the 6 months following this period, the patient developed signs and symptoms of progressing hydrocephalus and was found to have significant enlargement of his still completely thrombosed giant aneurysm. This complicated case highlights the controversy regarding the management of this difficult condition, particularly with regard to endovascular therapies, and also provides insight into the evolution of this dynamic disease process.

Sonographic examination of the adult brain.

Phased-array real-time transcranial ultrasound with a 2.5-MHz transducer was used to examine 23 normal adult volunteers and patients, and 8 selected patients with abnormalities proven by computed tomography. Normal cerebral landmarks were consistently seen and pulsed Doppler signals were often obtainable from central cerebral arteries. Dilated lateral ventricles, subdural hygromas, or cerebral masses were identified in 6 of the 8 patients. In the 2 others abnormal cases, known suprasellar aneurysms were missed. While current technology will not provide accurate screening for cerebral abnormalities, ultrasound imaging may often be adequate for follow-up examinations and for midline evaluation, and may provide simplified preoperative localization of some brain lesions. Doppler ultrasound examinations may be used for intracranial vessel hemodynamic evaluation.

Reversible panhypopituitarism caused by a suprasellar aneurysm

A case of panhypopituitarism and hyperprolactinemia caused by a giant intracranial aneurysm is presented. The case is unique because both the pattern of the pituitary dysfunction and the complete normalization of all pituitary function after decompression of the aneurysm demonstrate the importance of pure compressive effects of mass lesions on pituitary function. The literature regarding return of pituitary function after resection of sellar and suprasellar masses is reviewed, and a schema for classification of pituitary dysfunction caused by mass lesions is proposed. (Neurosurgery 10:604-611. 1982)

Computed Tomography and Angiography in the Diagnosis of Suprasellar Mass Lesions

We studied four cases in which the differentiation between a noncalcified suprasellar aneurysm and tuberculum meningioma, and a calcified suprasellar aneurysm and craniopharyngioma, could not be established by computed tomography scan alone. Cerebral angiography clearly showed both aneurysms.

Giant suprasellar aneurysm associated with optic stalk agenesis and unilateral anophthalmos

The authors report a patient with unilateral anophthalmos who had a large suprasellar aneurysm associated with aplasia of an optic nerve and the chiasmal commissure. The anatomical findings at craniotomy are described.

Suprasellar Aneurysm An Unusual Cause of Hypopituitarism

PANHYPOPITUITARISM, an uncommon clinical disorder, may result from a variety of underlying conditions. Chromophobe adenoma is perhaps the most frequent precipitating cause. Less common but confirmed causes include postpartum pituitary infarction, granulomatous disorders, head trauma, hemorrhage, suprasellar cyst, craniopharyngioma, and suprasellar aneurysm, which is presented here. Report of a Case A 55-year-old white woman was hospitalized because of a visual field defect. Additional complaints were bifrontal headache, 18-kg (40-lb) weight loss, alopecia, cold sensitivity, and increased sleep requirements. She denied having polydipsia, polyuria, or nocturia. She had been hypertensive for many years but had remained normotensive in the last 18 months without therapy. Her pregnancies had been uncomplicated, and she had reached an uneventful menopause at age 50 years. Vital signs were normal. The optic fundi showed mild congestion of retinal vessels but no papilledema, hemorrhage, or exudates. Visual field examination by perimetry showed a bitemporal hemianopsia. Axillary hair was

SUPRASELLAR ANEURYSM

We wish to report a case of suprasellar aneurysm exposed and incised at operation. A large muscle graft was packed into the aneurysmal sac. This is the sixth instance that we have found of a patient's surviving the opening of a suprasellar aneurysm. Since we have been able to find but few cases of this type in the literature, we wish to emphasize certain aspects of the problem of suprasellar aneurysm both from the diagnostic and from the therapeutic standpoint. The association of paralysis of the third, fourth, fifth and sixth cranial nerves with aneurysms of the infraclinoid portion of the internal carotid artery has become well known. Dandy 1 has reported several such cases of pure arterial aneurysm diagnosed by clinical means and cured by operation. A second type of aneurysm has been but little mentioned in the literature. To distinguish this type from the infraclinoid group, it is