Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment
Abstract We report an unusual case of subarachnoid hemorrhage caused by intraoperative rupture of an intracavernous carotid artery aneurysm coexisting with a prolactinoma. A 58-year-old man presenting with diplopia was found to have a left intracavernous carotid artery aneurysm encased by a suprasel...
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2014-03-01
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| Series: | Journal of Neurological Surgery Reports |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1364166 |
| _version_ | 1811223647903285248 |
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| author | Nobuyuki Akutsu Kohkichi Hosoda Kohei Ohta Hirotomo Tanaka Masaaki Taniguchi Eiji Kohmura |
| author_facet | Nobuyuki Akutsu Kohkichi Hosoda Kohei Ohta Hirotomo Tanaka Masaaki Taniguchi Eiji Kohmura |
| author_sort | Nobuyuki Akutsu |
| collection | DOAJ |
| description | Abstract
We report an unusual case of subarachnoid hemorrhage caused by intraoperative rupture of an intracavernous carotid artery aneurysm coexisting with a prolactinoma. A 58-year-old man presenting with diplopia was found to have a left intracavernous carotid artery aneurysm encased by a suprasellar tumor on magnetic resonance imaging. His serum prolactin level was 5036 ng/mL. Proximal ligation of the left internal carotid artery with a superficial temporal artery to middle cerebral artery anastomosis was scheduled. Because the patient's diplopia had deteriorated, we started him on cabergoline at a dose of 0.25 mg once a week. One month after administration of cabergoline, the diplopia was improved to some extent and serum prolactin was decreased to 290 ng/ml. Six weeks after starting the cabergoline, the patient underwent a left frontotemporal craniotomy to treat the aneurysm. When the dura mater was opened, abnormal brain swelling and obvious subarachnoid hemorrhage were observed. Postoperative computed tomography demonstrated a thick subarachnoid hemorrhage. This case suggests that medical therapy for a pituitary adenoma should be started after treatment for a coexisting intracavernous aneurysm is completed. |
| first_indexed | 2024-04-12T08:37:37Z |
| format | Article |
| id | doaj.art-931a6b972a694e62bb4ff0a30bea0859 |
| institution | Directory Open Access Journal |
| issn | 2193-6358 2193-6366 |
| language | English |
| last_indexed | 2024-04-12T08:37:37Z |
| publishDate | 2014-03-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Neurological Surgery Reports |
| spelling | doaj.art-931a6b972a694e62bb4ff0a30bea08592022-12-22T03:39:59ZengGeorg Thieme Verlag KGJournal of Neurological Surgery Reports2193-63582193-63662014-03-017501e73e7610.1055/s-0033-1364166Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline TreatmentNobuyuki Akutsu0Kohkichi Hosoda1Kohei Ohta2Hirotomo Tanaka3Masaaki Taniguchi4Eiji Kohmura5Department of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurosurgery, Kobe University Graduate School of Medicine, Hyogo, JapanAbstract We report an unusual case of subarachnoid hemorrhage caused by intraoperative rupture of an intracavernous carotid artery aneurysm coexisting with a prolactinoma. A 58-year-old man presenting with diplopia was found to have a left intracavernous carotid artery aneurysm encased by a suprasellar tumor on magnetic resonance imaging. His serum prolactin level was 5036 ng/mL. Proximal ligation of the left internal carotid artery with a superficial temporal artery to middle cerebral artery anastomosis was scheduled. Because the patient's diplopia had deteriorated, we started him on cabergoline at a dose of 0.25 mg once a week. One month after administration of cabergoline, the diplopia was improved to some extent and serum prolactin was decreased to 290 ng/ml. Six weeks after starting the cabergoline, the patient underwent a left frontotemporal craniotomy to treat the aneurysm. When the dura mater was opened, abnormal brain swelling and obvious subarachnoid hemorrhage were observed. Postoperative computed tomography demonstrated a thick subarachnoid hemorrhage. This case suggests that medical therapy for a pituitary adenoma should be started after treatment for a coexisting intracavernous aneurysm is completed.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1364166intracavernous aneurysmsubarachnoid hemorrhageprolactinomacabergoline |
| spellingShingle | Nobuyuki Akutsu Kohkichi Hosoda Kohei Ohta Hirotomo Tanaka Masaaki Taniguchi Eiji Kohmura Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment Journal of Neurological Surgery Reports intracavernous aneurysm subarachnoid hemorrhage prolactinoma cabergoline |
| title | Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment |
| title_full | Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment |
| title_fullStr | Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment |
| title_full_unstemmed | Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment |
| title_short | Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment |
| title_sort | subarachnoid hemorrhage due to rupture of an intracavernous carotid artery aneurysm coexisting with a prolactinoma under cabergoline treatment |
| topic | intracavernous aneurysm subarachnoid hemorrhage prolactinoma cabergoline |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1364166 |
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