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      Aneurisma gigante parasselar simulando tumor de hipófise Translated title: Giant paraselar aneurysm simulating pituitary tumour

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          Abstract

          Revisamos 7 pacientes com comprometimento da sela turca ao raio X do crânio que apresentavam aneurisma gigante da porção intracavernosa da artéria carótida (6 casos) e aneurisma da artéria comunicante anterior (1 caso). As alterações encontradas foram: cefaléia (7/7), oftalmoplegia complexa interessando III, IV e VI nervos cranianos (5/7) e comprometimento do V nervo (4/7), dor ocular (4/7). Outras alterações encontradas foram: sinais meníngeos (2/7), cegueira unilateral (1/7), hemiparesia (1/7) cacosmia (1/7) e quadrantanopsia bitemporal inferior (1/7). Cinco pacientes com aneurisma da porção intracavernosa da artéria carótida beneficiaram-se com a ligadura progressiva da artéria carótida interna a nível cervical; o outro paciente faleceu antes da realização da operação. O paciente com aneurisma da artéria comunicante anterior foi submetido a clipagem do aneurisma, tendo boa evolução. Baseados neste estudo e em concordância com a literatura, concluímos que o diagnóstico diferencial entre aneurisma localizado na região parasselar e outras patologias dessa área freqüentemente apresenta dificuldade. O diagnóstico definitivo requer a realização de angiografia cerebral. O tratamento cirúrgico, por ligadura da carótida interna na região cervical, é benéfico e quase desprovido de complicações.

          Translated abstract

          Seven cases of compromised pituitary fossa at the conventional skull X-ray, who had the final diagnosis of giant aneurysm of the intracavernous portion of the carotid artery (6 cases) and one of the anterior communicant artery, are reported. The main findings were: headache (7/7), complex ophtalmoplegia involving the III, IV and VI cranial nerves (5/7), compromised V cranial nerve (4/7) and eyeball pain (4/7). Other manifestations were: meningeal signs (2/7), unilateral blindness (1/7), hemiparesis (1/7), cacosmia (1/7) and inferior bitemporal quadrantanopsia (1/7). Five patients with intracavernous carotid artery aneurysm showed benefits with progressive occlusion of the internal carotid artery at the cervical level. One died before surgery. The case with anterior communicant artery aneurysm improved after its surgical clipping. Our data, in accord with the literature, support the conclusion that the differential diagnosis of aneurysms in the parasellar egion remains a very difficult task. The accurate final diagnosis requires cerebral angiography and the surgical treatment with progressive occlusion at the cervical portion of the internal carotid artery has a relatively low risk with promising results.

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          Large suprasellar aneurysms imitating pituitary tumour.

          Two patients had large (20--30 mm) suprasellar aneurysms with clinical findings resembling an expanding pituitary tumour. One aneurysm was giant (30 mm). Its delayed diagnosis for six years led to severe chiasmal compression. The other aneurysm was compressing the optic nerve. Visual improvement resulted after surgery.
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            Unruptured aneurysm of the supraclinoid carotid artery. A treatable cause of blindness.

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              • Book: not found

              Treatment of pituitary adenomas

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                Author and article information

                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )
                0004-282X
                1678-4227
                December 1988
                : 46
                : 4
                : 417-423
                Affiliations
                [02] orgnameHospital de Base do Distrito Federal orgdiv1Núcleo de Neuroendocrinologia
                [01] orgnameUniversidade de Brasília
                Article
                S0004-282X1988000400015 S0004-282X(88)04600415
                b7430e30-e917-4825-96e3-6dc34ae80d76

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 7
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                SciELO Brazil


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