Unusual Presentation of Vasospasm Masking Underlying Pseudoaneurysm After Endoscopic Transsphenoidal Surgery in Pituitary Macroadenoma.

Abstract

Vascular complications during transsphenoidal surgery can be devastating. Direct vascular injury during surgery can lead to various complications including pseudoaneurysm formation. Postoperative hematoma and direct vascular handling due to arachnoid tear can induce vasospasm. The vasospasm might present with varying clinical symptomatology and at times masks the underlying pathology as well. We present here a case of pituitary macroadenoma in whom the vasospasm caused vision loss and also concealed a developing pseudoaneurysm. Angiograms at regular intervals should be performed in cases where intraoperative vascular injury is suspected to detect such aneurysms and prevent catastrophe.