A Giant Internal Carotid Bifurcation Aneurysm as a Rare and Dangerous Differential Diagnosis of a Craniopharyngioma.
| Autor: | Perret CM; Neurological Surgery, Hospital Municipal Miguel Couto, Rio de Janeiro, BRA.; Neuroscience, Federal University of Rio de Janeiro, Rio de Janeiro, BRA., Bertani R; Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, BRA., W Koester S; Neurosurgery, Vanderbilt University School of Medicine, Nashville, USA., Santa Maria PE; Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, BRA., Von Zuben D; Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, BRA., Batista S; Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, BRA., Schiavini HC; Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, BRA., Landeiro JA; Neurosurgery, Hospital Universitario Antonio Pedro, Rio de Janeiro, BRA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2022 Jan 25; Vol. 14 (1), pp. e21588. Date of Electronic Publication: 2022 Jan 25 (Print Publication: 2022). |
| DOI: | 10.7759/cureus.21588 |
| Abstrakt: | Craniopharyngiomas are supra/parasellar lesions that often present with general, unspecific symptoms. Similarly, internal carotid artery (ICA) bifurcation giant aneurysms may also produce calcified, heterogeneous, parasellar expansive lesions, posing a relevant differential diagnosis due to their inherently different surgical strategies and risks. We report the case of a 54-year-old female presenting with progressive disorientation and apathetic behavior. CT and MRI reports described a suprasellar heterogenous mass with calcifications associated with an adjacent, laterally located fluid collection suggestive of a craniopharyngioma. During the surgical procedure, perfuse and unexplained arterial bleeding ensued, prompting the surgical team to review a previous contrast-enhanced CT scan. Careful inspection revealed an image suggestive of vascular pathology, with an area of continuous hyperdensity along the right ICA bifurcation. The Sylvian fissure was dissected, and an aneurysmal neck was encountered and successfully clipped. Giant intracranial aneurysms are rare but essential differential diagnoses to be considered during the workup and surgical approach toward parasellar mass lesions. This case illustrates the importance of performing a CT angiogram (CTA) for skull base lesions, even when the size is more suggestive of tumor pathology. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Perret et al.) |
| Databáze: | MEDLINE |
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