{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:54:18Z","timestamp":1785372858445,"version":"3.55.0"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,4,18]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Vascular injuries during pituitary surgery are feared as they can lead to serious disability and can be life threatening. We are describing a case of severe intractable epistaxis following endoscopic transnasal transsphenoidal surgery for pituitary tumour due to a sphenopalatine artery pseudoaneurysm which was successfully managed using endovascular embolisation techniques. Very few cases of sphenopalatine artery pseudoaneurysm following endoscopic nasal surgery have been described. A middle aged male patient with a pituitary macroadenoma underwent endoscopic transsphenoidal pituitary surgery and returned to us after 3\u2009days of discharge with severe epistaxis. Digital subtraction angiography showed contrast leakage and left sphenopalatine artery pseudoaneurysm. Glue embolisation of the distal sphenopalatine branches and pseudoaneurysm was done. Good occlusion of pseudoaneurysm was seen. Such a diagnosis for epistaxis following endoscopic transnasal surgery should be borne in mind, so prompt treatment can be planned to avoid life threatening complications.<\/jats:p>","DOI":"10.1136\/bcr-2022-253998","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T11:04:04Z","timestamp":1683025444000},"page":"e253998","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Endovascular management of a sphenopalatine artery pseudoaneurysm: a rare cause of delayed intractable epistaxis following endoscopic transsphenoidal pituitary surgery"],"prefix":"10.1136","volume":"16","author":[{"given":"Sreehari Nirmala","family":"Ramachandran","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Cochin, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayyadurai","family":"Retnathankom","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Cochin, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishant","family":"Rege","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Cochin, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna Tej","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Amrita Institute of Medical Sciences, Cochin, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"2025082702262985000_16.5.e253998.1","doi-asserted-by":"crossref","first-page":"S1053","DOI":"10.4103\/2152-7806.196369","article-title":"Sphenopalatine arteriovenous fistula complicating transsphenoidal pituitary surgery: a rare cause of delayed epistaxis treatable by endovascular embolization","volume":"7","author":"Eneling","year":"2016","journal-title":"Surg Neurol Int"},{"key":"2025082702262985000_16.5.e253998.2","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.1177\/014556131209100215","article-title":"Sphenopalatine artery pseudoaneurysm after endoscopic sinus surgery: a case report and literature review","volume":"91","author":"Campbell","year":"2012","journal-title":"Ear Nose Throat J"},{"key":"2025082702262985000_16.5.e253998.3","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000000696"},{"key":"2025082702262985000_16.5.e253998.4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.26502\/fjsrs0028","article-title":"Endovascular approach to ruptured sphenopalatine artery: a case report and literature review","volume":"03","author":"Saha","year":"2021","journal-title":"J Spine Res Surg"},{"key":"2025082702262985000_16.5.e253998.5","doi-asserted-by":"publisher","DOI":"10.1177\/159101991301900116"},{"key":"2025082702262985000_16.5.e253998.6","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32814b06ed"},{"key":"2025082702262985000_16.5.e253998.7","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2003.50100"},{"key":"2025082702262985000_16.5.e253998.8","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31815708d0"},{"key":"2025082702262985000_16.5.e253998.9","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2006.20.2928"},{"key":"2025082702262985000_16.5.e253998.10","first-page":"655","article-title":"Arterial injuries in transsphenoidal surgery for pituitary adenoma; the role of angiography and endovascular treatment","volume":"18","author":"Raymond","year":"1997","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082702262985000_16.5.e253998.11","first-page":"236","article-title":"Delayed epistaxis resulting from external carotid artery injury requiring embolization: a rare complication of transsphenoidal surgery: case report","volume":"47","author":"Cockroft","year":"2000","journal-title":"Neurosurgery"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:26:41Z","timestamp":1756286801000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,2]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bcr-2022-253998"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253998","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}