Pituitary apoplexy caused by ruptured internal carotid artery aneurysm

Background and Purpose-We report the first case of pituitary apoplexy caused by the rupture of an intracavernous carotid artery aneurysm embedded in a pituitary adenoma. Case Description-A 46-year-old man presented with clinical and CT findings typical of pituitary apoplexy. MRI showed an unusual flow-void protrusion into the intratumoral hematoma, which, however, was not diagnosed as a ruptured aneurysm until severe intraoperative bleeding occurred. Angiography after surgery revealed an intracavernous carotid artery aneurysm. Conclusions-The possible association of adenoma and aneurysmal rupture should be kept in mind when assessing any case of pituitary apoplexy.