A FURTHER CASE OF GIANT INTRASELLAR CAROTID ANEURYSM MIMICKING A PITUITARY-ADENOMA - THE RELEVANCE OF A MULTIVARIATE APPROACH IN DIFFERENTIAL-DIAGNOSIS

We describe a 53 year old woman who progressively showed a left extrin sic oculomotor paresis, at first suggesting ocular myasthenia, which w as ruled out by a negative Tensilon test. A CT scan of the brain revea led a pituitary mass consistent with an adenoma which was confirmed by endocrinological investigation and standard MRI. Carotid angiography, performed the day before the scheduled trans-sphenoidal surgery, clea rly showed a giant intrasellar aneurysm of the left carotid syphon. An extra-intracranial by-pass with occlusion of the internal carotid art ery was successfully executed.