PMC7332490_01
Angio-CT scan. (a) Cavernous segment of the right internal carotid artery, below the line of projection of the planum sphenoidale (red dotted line). (b) Cavernous segment of the left internal carotid artery with its posterior genu above the line of projection of the planum sphenoidale (red dotted line). (c) Enlargement of the sella turcica and left carotid artery laterally displaced. (d) Superior displacement of the cavernous segment of the internal carotid artery and an aneurysm close to the communicating segment of the internal carotid artery (white arrow).
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F1
SAH, but showed an expansive process in the sella turcica associated with sellar enlargement [Figure 1]. SAH was then confirmed by lumbar puncture (Fisher I).
Three-dimensional reconstruction of cranial angiotomography showing saccular aneurysm (arrow) in the cavernous segment of the left internal carotid artery.
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F2
A cranial angio-CT was made and revealed an intradural saccular aneurysm in the cavernous segment of the left internal carotid artery (ICA) [Figure 2].
(a) Intraoperative image showing the carotid aneurysm (white arrow), compressing the left oculomotor nerve; (b) schematic representation of the aneurysm (white arrow), compressing the oculomotor nerve; (c) image after microsurgical clipping (black arrow). AC: Anterior clinoid; CN II: Optic cranial nerve; CN III: Oculomotor cranial nerve; FL: Frontal lobe; ICA: Internal carotid artery; R: Fixed retractor.
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F3
Postoperative left carotid angiography (a: Frontal; b: Oblique; and c: Lateral) showing the clip adjacent to the cavernous segment of the left internal carotid artery, with complete aneurysm occlusion.
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F4
He underwent control cerebral angiography on the 2nd postoperative day that demonstrated complete aneurysm occlusion [Figure 4], with no residual neck and no vasospasm and complemented the study with magnetic resonance imaging (MRI) of the sella turcica that was consistent of pituitary macroadenoma with apoplexy [Figure 5].
Sella turcica magnetic resonance imaging consistent with pituitary macroadenoma with apoplexia (a: Axial fluid-attenuated inversion recovery; b: Coronal T1 with gadolinium; and c: Sagittal T1 with gadolinium).
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F5
He underwent control cerebral angiography on the 2nd postoperative day that demonstrated complete aneurysm occlusion [Figure 4], with no residual neck and no vasospasm and complemented the study with magnetic resonance imaging (MRI) of the sella turcica that was consistent of pituitary macroadenoma with apoplexy [Figure 5].