Coexistence of aneurysmal subarachnoid haemorrhage and pituitary apoplexy: Case report and review of the literature

J Clin Neurosci. 2003 Jul;10(4):478-82. doi: 10.1016/s0967-5868(02)00323-5.

Abstract

A case of aneurysmal subarachnoid haemorrhage with associated haemorrhagic infarction of a growth hormone secreting pituitary macroadenoma is presented. The subarachnoid haemorrhage was not identifiable on CT, but was apparent on MRI. Angiography revealed a 7mm right posterior communicating aneurysm, a 3mm left A1 segment anterior cerebral aneurysm, and vasospasm. Surgery was performed through a right pterional/subfrontal approach, clipping both aneurysms and debulking the tumour. The left A1 aneurysm was the site of subarachnoid haemorrhage. There was evidence of haemorrhagic infarction of the pituitary tumour. Although rupture of an aneurysm into a pituitary tumour has been previously reported, this is the first case reported of aneurysmal subarachnoid haemorrhage with coexisting pituitary apoplexy where the aneurysm had not bled directly into the pituitary tumour. The literature regarding the association between pituitary tumours and aneurysm is reviewed.

Publication types

  • Case Reports

MeSH terms

  • Enzymes / blood
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pituitary Apoplexy / complications*
  • Pituitary Apoplexy / diagnostic imaging
  • Pituitary Apoplexy / pathology
  • Pituitary Apoplexy / surgery*
  • Prolactin / blood
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / pathology
  • Subarachnoid Hemorrhage / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Unconsciousness / etiology
  • Visual Fields

Substances

  • Enzymes
  • Prolactin