GIANT INTRASELLAR ANEURYSM PRESENTING WITH PANHYPOPITUITARISM AND SUBARACHNOID HEMORRHAGE - CASE-REPORT AND LITERATURE-REVIEW

A 52-year-old woman was admitted to our hospital presenting with subar achnoid hemorrhage, left ophthalmoplegia, and right hemiparesis. Previ ous symptoms and signs suggested the presence of panhypopituitarism. A giant intracranial aneurysm of the internal carotid artery, diagnosed by magnetic resonance imaging, showed the characteristic flow void ph enomenon with black appearance. Analysis of endocrine function disclos ed panhypopituitarism and hyperprolactinemia. After proximal balloon o cclusion of the aneurysm, diabetes insipidus developed. Pituitary func tion reassessed 6 months after initial admission confirmed anterior an d posterior hypopituitarism and hyperprolactinemia. Possible mechanism s are discussed. A review of the literature on pituitary dysfunction c aused by carotid artery aneurysms discloses that the pituitary-gonadal axis is the most frequently involved (67.5% of cases), followed by th e pituitary-adrenal axis (48.6%) and the pituitary-thyroid axis (40.5% ). These frequencies are very similar to those described in other type s of hypopituitarism.