Hypopituitarism Resulting from a Right Internal Carotid Artery Aneurysm: A Case Report
Poster #: 070
Session/Time: A
Author:
William Wittler Zak, BS
Mentor:
Peter Laplace, MD
Research Type: Case Report
Abstract
INTRODUCTION:
Internal carotid artery aneurysms are very rare but are associated with high mortality rates due to the possibility of rupture. Patients may present with nonspecific symptoms such as headache, orbital pain, and diplopia due to mass effect and compression of surrounding structures. These aneurysms may erode surrounding bone leading to further complications, such as hypopituitarism due to invasion into the sella turcica and pituitary compression.
CASE INFORMATION:
MATION: A 76-year-old woman with hyperlipidemia presented to her primary care office with a persistent headaches and double vision. She was subsequently advised to go to the emergency department for further work up. She underwent CT scan which revealed a giant right internal carotid artery aneurysm with pressure erosion and protrusion into the sella turcica. She then underwent a pipeline flex-shield embolization, which led to correction of the aneurysm and resolution of her headache, as well as partial resolution of diplopia. She was later diagnosed with hypopituitarism leading to adrenal insufficiency and hypothyroidism that was treated with hydrocortisone and levothyroxine.
DISCUSSION/CLINICAL FINDINGS:
While rare, patients who present with general, unspecific neurological symptoms should be assessed for internal carotid artery aneurysm as they require prompt evaluation, diagnosis, and treatment to prevent further growth, rupture, and complications. Surgical intervention with embolization has demonstrated to be a safe and highly efficacious treatment for internal carotid artery aneurysms. Hypopituitarism is a possible side effect, and patients may be treated with hormone therapy.
Internal carotid artery aneurysms are very rare but are associated with high mortality rates due to the possibility of rupture. Patients may present with nonspecific symptoms such as headache, orbital pain, and diplopia due to mass effect and compression of surrounding structures. These aneurysms may erode surrounding bone leading to further complications, such as hypopituitarism due to invasion into the sella turcica and pituitary compression.
CASE INFORMATION:
MATION: A 76-year-old woman with hyperlipidemia presented to her primary care office with a persistent headaches and double vision. She was subsequently advised to go to the emergency department for further work up. She underwent CT scan which revealed a giant right internal carotid artery aneurysm with pressure erosion and protrusion into the sella turcica. She then underwent a pipeline flex-shield embolization, which led to correction of the aneurysm and resolution of her headache, as well as partial resolution of diplopia. She was later diagnosed with hypopituitarism leading to adrenal insufficiency and hypothyroidism that was treated with hydrocortisone and levothyroxine.
DISCUSSION/CLINICAL FINDINGS:
While rare, patients who present with general, unspecific neurological symptoms should be assessed for internal carotid artery aneurysm as they require prompt evaluation, diagnosis, and treatment to prevent further growth, rupture, and complications. Surgical intervention with embolization has demonstrated to be a safe and highly efficacious treatment for internal carotid artery aneurysms. Hypopituitarism is a possible side effect, and patients may be treated with hormone therapy.