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Published in: Acta Neurochirurgica 1/2019

01-01-2019 | Case Report - Vascular Neurosurgery - Aneurysm

Clipping of a superior hypophyseal artery aneurysm during endoscopic transnasal removal of a Rathke cleft cyst: a case report

Authors: Carlo Serra, Martina Sebök, Lukas Widmer, Marian Christoph Neidert, Luca Regli

Published in: Acta Neurochirurgica | Issue 1/2019

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Abstract

The concomitant presence of an aneurysm in contact with a sellar lesion usually contraindicates a transsphenoidal approach (TSS). Clipping of an intracranial aneurysm is however possible in highly selected cases also through an endoscopic TSS approach, as long as the basic principles of cerebrovascular surgery are respected. We report thus on a case of a patient harboring a Rathke cleft cyst (RCC) and an aneurysm of the carotid artery (ICA) in close contact with the RCC. The anatomical characteristics of both lesions warranted an endoscopic TSS for removal of the RCC and clipping of the aneurysm during the same approach.
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Literature
1.
go back to reference Bouthillier A, van Loveren HR, Keller JT (1996) Segments of the internal carotid artery: a new classification. Neurosurgery 38:425–432; discussion 432-423 Bouthillier A, van Loveren HR, Keller JT (1996) Segments of the internal carotid artery: a new classification. Neurosurgery 38:425–432; discussion 432-423
2.
go back to reference Dehdashti AR, Ganna A, Witterick I, Gentili F (2009) Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 64:677–687 discussion 687-679 CrossRef Dehdashti AR, Ganna A, Witterick I, Gentili F (2009) Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 64:677–687 discussion 687-679 CrossRef
3.
go back to reference Duan Y, Blackham K, Nelson J, Selman W, Bambakidis N (2015) Analysis of short-term total hospital costs and current primary cost drivers of coiling versus clipping for unruptured intracranial aneurysms. Journal of neurointerventional surgery 7:614–618CrossRefPubMed Duan Y, Blackham K, Nelson J, Selman W, Bambakidis N (2015) Analysis of short-term total hospital costs and current primary cost drivers of coiling versus clipping for unruptured intracranial aneurysms. Journal of neurointerventional surgery 7:614–618CrossRefPubMed
4.
go back to reference Fan J, Peng Y, Qi S, Zhang XA, Qiu B, Pan J (2013) Individualized surgical strategies for Rathke cleft cyst based on cyst location. J Neurosurg 119:1437–1446CrossRefPubMed Fan J, Peng Y, Qi S, Zhang XA, Qiu B, Pan J (2013) Individualized surgical strategies for Rathke cleft cyst based on cyst location. J Neurosurg 119:1437–1446CrossRefPubMed
5.
go back to reference Froelich S, Cebula H, Debry C, Boyer P (2011) Anterior communicating artery aneurysm clipped via an endoscopic endonasal approach: technical note. Neurosurgery 68:310–316 discussion 315-316 CrossRefPubMed Froelich S, Cebula H, Debry C, Boyer P (2011) Anterior communicating artery aneurysm clipped via an endoscopic endonasal approach: technical note. Neurosurgery 68:310–316 discussion 315-316 CrossRefPubMed
6.
go back to reference Frontera JA, Moatti J, de los Reyes KM, McCullough S, Moyle H, Bederson JB, Patel A (2014) Safety and cost of stent-assisted coiling of unruptured intracranial aneurysms compared with coiling or clipping. Journal of neurointerventional surgery 6:65–71CrossRefPubMed Frontera JA, Moatti J, de los Reyes KM, McCullough S, Moyle H, Bederson JB, Patel A (2014) Safety and cost of stent-assisted coiling of unruptured intracranial aneurysms compared with coiling or clipping. Journal of neurointerventional surgery 6:65–71CrossRefPubMed
7.
go back to reference Gardner PA, Vaz-Guimaraes F, Jankowitz B, Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH (2015) Endoscopic endonasal clipping of intracranial aneurysms: surgical technique and results. World Neurosurg 84:1380–1393CrossRefPubMed Gardner PA, Vaz-Guimaraes F, Jankowitz B, Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH (2015) Endoscopic endonasal clipping of intracranial aneurysms: surgical technique and results. World Neurosurg 84:1380–1393CrossRefPubMed
8.
go back to reference Greving JP, Wermer MJ, Brown RD Jr, Morita A, Juvela S, Yonekura M, Ishibashi T, Torner JC, Nakayama T, Rinkel GJ, Algra A (2014) Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol 13:59–66CrossRefPubMed Greving JP, Wermer MJ, Brown RD Jr, Morita A, Juvela S, Yonekura M, Ishibashi T, Torner JC, Nakayama T, Rinkel GJ, Algra A (2014) Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol 13:59–66CrossRefPubMed
9.
go back to reference Habibi Z, Miri SM, Sheikhrezaei A (2015) Pituitary macroadenoma coexistent with a posterior circulation aneurysm leading to subarachnoidal hemorrhage during transsphenoidal surgery. Turkish neurosurgery 25:469–474PubMed Habibi Z, Miri SM, Sheikhrezaei A (2015) Pituitary macroadenoma coexistent with a posterior circulation aneurysm leading to subarachnoidal hemorrhage during transsphenoidal surgery. Turkish neurosurgery 25:469–474PubMed
10.
go back to reference Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:1882–1886CrossRef Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:1882–1886CrossRef
11.
go back to reference Han SJ, Rolston JD, Jahangiri A, Aghi MK (2014) Rathke’s cleft cysts: review of natural history and surgical outcomes. J Neuro-Oncol 117:197–203CrossRef Han SJ, Rolston JD, Jahangiri A, Aghi MK (2014) Rathke’s cleft cysts: review of natural history and surgical outcomes. J Neuro-Oncol 117:197–203CrossRef
12.
go back to reference Jimbo H, Ichikawa M, Fukami S, Otsuka K, Tsurukiri J, Sunaga S, Ikeda Y (2016) Rapid de novo aneurysm formation after Rathke cleft cyst rupture. World Neurosurg 88(690):e611–e696 Jimbo H, Ichikawa M, Fukami S, Otsuka K, Tsurukiri J, Sunaga S, Ikeda Y (2016) Rapid de novo aneurysm formation after Rathke cleft cyst rupture. World Neurosurg 88(690):e611–e696
13.
go back to reference Kassam AB, Gardner PA, Mintz A, Snyderman CH, Carrau RL, Horowitz M (2007) Endoscopic endonasal clipping of an unsecured superior hypophyseal artery aneurysm. Technical note J Neurosurg 107:1047–1052CrossRefPubMed Kassam AB, Gardner PA, Mintz A, Snyderman CH, Carrau RL, Horowitz M (2007) Endoscopic endonasal clipping of an unsecured superior hypophyseal artery aneurysm. Technical note J Neurosurg 107:1047–1052CrossRefPubMed
14.
go back to reference Kato T, Sawamura Y, Abe H, Nagashima M (1998) Transsphenoidal-transtuberculum sellae approach for supradiaphragmatic tumours: technical note. Acta Neurochir 140:715–718 discussion 719 CrossRefPubMed Kato T, Sawamura Y, Abe H, Nagashima M (1998) Transsphenoidal-transtuberculum sellae approach for supradiaphragmatic tumours: technical note. Acta Neurochir 140:715–718 discussion 719 CrossRefPubMed
15.
go back to reference Kitai R, Yamauchi T, Arai Y, Hosoda T, Hashimoto N, Tsunetoshi K, Higashino Y, Kikuta KI (2017) Deflation of a Rathke cleft cyst triggered rupture of a superior hypophyseal artery aneurysm: a case report. Br J Neurosurg:1–3 Kitai R, Yamauchi T, Arai Y, Hosoda T, Hashimoto N, Tsunetoshi K, Higashino Y, Kikuta KI (2017) Deflation of a Rathke cleft cyst triggered rupture of a superior hypophyseal artery aneurysm: a case report. Br J Neurosurg:1–3
16.
go back to reference Oh MC, Kim EH, Kim SH (2012) Coexistence of intracranial aneurysm in 800 patients with surgically confirmed pituitary adenoma. J Neurosurg 116:942–947CrossRefPubMed Oh MC, Kim EH, Kim SH (2012) Coexistence of intracranial aneurysm in 800 patients with surgically confirmed pituitary adenoma. J Neurosurg 116:942–947CrossRefPubMed
17.
go back to reference Pant B, Arita K, Kurisu K, Tominaga A, Eguchi K, Uozumi T (1997) Incidence of intracranial aneurysm associated with pituitary adenoma. Neurosurg Rev 20:13–17CrossRefPubMed Pant B, Arita K, Kurisu K, Tominaga A, Eguchi K, Uozumi T (1997) Incidence of intracranial aneurysm associated with pituitary adenoma. Neurosurg Rev 20:13–17CrossRefPubMed
18.
go back to reference Raper DM, Ding D, Evans E, Starke RM, Crowley RW, Liu KC, Oldfield EH, Jane JA, Jr. (2017) Clinical features, management considerations and outcomes in case series of patients with parasellar intracranial aneurysms undergoing anterior skull base surgery. World Neurosurg 99:424–432 Raper DM, Ding D, Evans E, Starke RM, Crowley RW, Liu KC, Oldfield EH, Jane JA, Jr. (2017) Clinical features, management considerations and outcomes in case series of patients with parasellar intracranial aneurysms undergoing anterior skull base surgery. World Neurosurg 99:424–432
19.
go back to reference Rustagi T, Uy EM, Rai M, Kannan S, Senatus P (2011) Intracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection. Conn Med 75:393–398PubMed Rustagi T, Uy EM, Rai M, Kannan S, Senatus P (2011) Intracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection. Conn Med 75:393–398PubMed
20.
go back to reference Takeuchi S, Wada K, Sakakibara F, Nawashiro H, Mori K (2013) Anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma. Br J Neurosurg 27:102–104CrossRefPubMed Takeuchi S, Wada K, Sakakibara F, Nawashiro H, Mori K (2013) Anterior cerebral artery dissecting aneurysm associated with untreated craniopharyngioma. Br J Neurosurg 27:102–104CrossRefPubMed
21.
go back to reference Tsuchida T, Tanaka R, Yokoyama M, Sato H (1983) Rupture of anterior communicating artery aneurysm during transsphenoidal surgery for pituitary adenoma. Surg Neurol 20:67–70CrossRefPubMed Tsuchida T, Tanaka R, Yokoyama M, Sato H (1983) Rupture of anterior communicating artery aneurysm during transsphenoidal surgery for pituitary adenoma. Surg Neurol 20:67–70CrossRefPubMed
22.
go back to reference Yamada S, Yamada SM, Hirohata T, Ishii Y, Hoya K, Murakami M, Matsuno A (2012) Endoscopic extracapsular removal of pituitary adenoma: the importance of pretreatment of an adjacent unruptured internal carotid artery aneurysm. Case Rep Neurol Med 2012:891847 Yamada S, Yamada SM, Hirohata T, Ishii Y, Hoya K, Murakami M, Matsuno A (2012) Endoscopic extracapsular removal of pituitary adenoma: the importance of pretreatment of an adjacent unruptured internal carotid artery aneurysm. Case Rep Neurol Med 2012:891847
23.
go back to reference Yu K, Herwadkar A, Kearney T, Gnanalingham KK (2011) Pituitary adenoma and incidental superior hypophyseal aneurysm. Br J Neurosurg 25:432–433CrossRefPubMed Yu K, Herwadkar A, Kearney T, Gnanalingham KK (2011) Pituitary adenoma and incidental superior hypophyseal aneurysm. Br J Neurosurg 25:432–433CrossRefPubMed
Metadata
Title
Clipping of a superior hypophyseal artery aneurysm during endoscopic transnasal removal of a Rathke cleft cyst: a case report
Authors
Carlo Serra
Martina Sebök
Lukas Widmer
Marian Christoph Neidert
Luca Regli
Publication date
01-01-2019
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-018-3728-0

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