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Journal of Korean Neurosurgical Society 2003;34(3): 249-251.
Pituitary Apoplexy Mimicking Aneurysmal Rupture of Anterior Communicating Artery.
Young Gyu Kim, Jong Sun Lee, Moon Sun Park, Ho Gyun Ha
Department of Neurosurgery, Eulji University School of Medicine, Daejeon, Korea. jslee@eulji.ac.kr
Pituitary apoplexy presenting with subarachnoid haemorrhage(SAH) is rare and thus may be easily mistaken for aneurysmal rupture. The authors report a case of pituitary apoplexy presented with SAH mimicking aneurysmal rupture of anterior communicating artery. A 70-year-old woman presented with sudden severe headache, vomiting and drowsiness. Computerized tomography showed diffuse SAH in basal cistern and enhancing sellar mass lesion that was overlooked. Because cerebral angiography showed a suspicious small aneurysmal sac at the origin of anterior communicating artery, we regarded it as an aneurysmal rupture. Craniotomy was performed but we could not find any aneurysm. There was a definite hemorrhagic mass lesion in the sellar and suprasellar area. Histopathological examination revealed a micronodular pituitary adenoma with hemorrhage. The authors stress that pituitary apoplexy must be included in the differential diagnosis of SAH, and proper preoperative radiologic imaging and careful interpretation is demanding for rule out the possibility of pituitary apoplexy.
Key Words: Pituitary apoplexy; Subarachnoid hemorrhage; Anterior communicating artery; Aneurysm
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