Carotid artery occlusion due to pituitary apoplexy

Abstract

Cerebral stroke caused by carotid arteries occlusion are rare. A 25-year-old man presented with history of frontal headache and a right cavernous sinus syndrome was admitted to our hospital with a magnetic resonance (MR) imaging showing a nodular mass in sella, suprasellar and infrasellar portion with extension through the right cavernous sinus. A day after admittance, he presented a sudden severe headache, visual and arousal disturbance with signs of herniation syndrome. The Computed Tomography revealed a right internal carotid territory infarction. A decompressive craniectomy was performed. The histological diagnosis was consistent with a non-functioning pituitary adenoma with hemorrhagic findings. The patient’s neurological status improved but he persisted clinically with left hemiplegia and cavernous sinus syndrome. This case is a rare presentation of pituitary apoplexy with elevated intracranial pressure caused by cerebral stroke due to mechanical obstruction of internal carotid artery.