PDF(Pubmed)
Abstract：
Here, we present a case report on internal carotid artery pseudoaneurysm (ICAP) which highlights a rare but potentially life-threatening complication of transsphenoidal pituitary surgery. A 32-year-old male underwent resection of a pituitary tumor and developed a large cerebrospinal fluid (CSF) leak during surgery, which was reconstructed with a fat graft and nasoseptal flap. Postoperatively, he was recovering well and discharged without complications; however, eight days after surgery he returned with massive epistaxis and hematemesis. This was initially managed with endoscopic exploration, nasal packing, and transfusion of blood products. Imaging revealed a pseudoaneurysm on the right internal carotid artery. The patient was started on aspirin and clopidogrel, and a flow diverter stent was placed without complications. Our case emphasizes the importance of prompt recognition and management of vascular injuries such as an internal carotid pseudoaneurysm after transsphenoidal pituitary surgery to prevent catastrophic outcomes.
摘要：
这里,我们提出了一个关于颈内动脉假性动脉瘤(ICAP)的病例报告,该病例报告强调了一种罕见但可能危及生命的经蝶入路垂体手术并发症.一名32岁的男性接受了垂体瘤的切除，并在手术过程中出现了大量的脑脊液（CSF）泄漏，用脂肪移植物和鼻中隔皮瓣重建。术后,他恢复良好，没有并发症出院；然而，手术八天后，他出现了大量的鼻出血和呕血。这最初是通过内窥镜探查来管理的，鼻腔填塞,和输血。影像学显示右侧颈内动脉有假性动脉瘤。患者开始服用阿司匹林和氯吡格雷，并放置了分流支架，无并发症。我们的案例强调了在经蝶入路垂体手术后迅速识别和处理血管损伤（例如颈内动脉假性动脉瘤）以防止灾难性后果的重要性。
