PMC8769433_01
(A and B) Preoperative MRI shows a sellar mass with significant upper extension. (C) Preoperative MRA identified no lesions that can cause subarachnoid hemorrhage.
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F1
MRI demonstrated a tumor with the suprasellar extension compressing the optic nerve and chiasma (maximum diameter was 2.8 cm) (Figs. 1A and 1B). MRA was unremarkable without any possible lesions causing SAH (Fig. 1C).
(A-C) CT taken just after the tumor removal shows unexpected small amount of the subarachnoid hematoma in the suprasellar-prepontine cistern. (D-F) The second CT shows the subarachnoid hematoma, which increased and spread into the ambient cistern and the right sylvian fissure.
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F2
Unexpectedly, CT revealed a small subarachnoid hematoma in the suprasellar-prepontine cistern (Figs. 2A-2C). It demonstrated that the subarachnoid hematoma increased in size and spread into the ambient cistern and the right sylvian fissure (Figs. 2D and 2E).
(A and B) The postoperative CT shows the extent of the osteodural opening over the sellar floor and presellar area by eTSS, and the suprasellar hematoma removal.
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F3
We performed the wide osteodural opening over the sellar floor and presellar area (ext.TSS) to open the suprasellar cistern and to easily remove the hematoma that is mainly located in the suprasellar region (Figs. 3A and 3B).