Endosaccular embolization of an intrasellar aneurysm with hypopituitarism: Case report

Mutsumi Fujii, Osamu Tone, Hiroki Tomita, Masashi Tamaki, Hideaki Akimoto, Keigo Shigeta, Oltea Sampetrean, Kazuo Kanno, Mika Matsushita

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

An 81-year-old male presented with weight loss and hyponatremia. A baseline endocrinological examination revealed anterior pituitary dysfunction. A computed tomography and MRI revealed a large, unruptured intrasellar aneurysm protruding from the right internal carotid artery and pushing the pituitary stalk leftward. The patient developed polyuria and polydipsia from 10 days after commencing corticosteroid supplementation and was diagnosed with partial central diabetes insipidus (DI). Balloon assisted endosaccular embolization was performed about one month after the posterior pituitary dysfunction was identified. The unruptured aneurysm was successfully embolized with Guglielmi detachable coils (GDCs) without narrowing of the parent vessel. DI resolved completely and the posterior pituitary dysfunction imploved soon after endosaccular embolization. The remission of DI after coil embolization suggested that the DI might have been induced by the progressive mass effect of the aneurysm rather than by the steroid. An endocrinological evaluation and cerebral angiography confirmed partial recovery of anterior pituitary dysfunction and almost complete obliteration of the aneurysm, respectively, at 1 year after the operation. We report a case of hypopituitarism secondary to the large intrasellar aneurysm. This aneurysm was embolized with GDCs, resulting in partial recovery of anterior pituitary dysfunction and complete recovery of posterior pituitary dysfunction.

Original languageEnglish
Pages (from-to)329-337
Number of pages9
JournalNeurological Surgery
Volume36
Issue number4
Publication statusPublished - 2008 Apr 1
Externally publishedYes

Keywords

  • Endosaccular embolization
  • Hypopituitarism
  • Internal carotid aneurysm
  • Intrasellar aneurysm
  • Mass lesion

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Fujii, M., Tone, O., Tomita, H., Tamaki, M., Akimoto, H., Shigeta, K., Sampetrean, O., Kanno, K., & Matsushita, M. (2008). Endosaccular embolization of an intrasellar aneurysm with hypopituitarism: Case report. Neurological Surgery, 36(4), 329-337.