Acute ICA occlusion due to pituitary apoplexy resulting In Internal Carotid Artery Occlusion and Stroke: Case Report, Review of The Literature, and Treatment Rationale

We report the case of a 63 year-old man who presented with sudden-onset, severe headache. Work-up revealed a hemorrhagic pituitary macroadenoma. He then suffered sudden-onset aphasia and right hemiparesis. Further evaluation revealed left ICA occlusion. Emergent transsphenoidal resection of the tumor produced recanalization of the occluded ICA, but his neurological symptoms persisted. ICA occlusion following pituitary tumor apoplexy is a rare event that must be recognized early for optimal patient outcomes. We report the first case with demonstration of carotid recanalization after tumor resection, review the incidence of ICA occlusion due to pituitary tumors, describe the possible mechanisms, and recommend optimal treatment strategies.