{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:04:46Z","timestamp":1790067886884,"version":"4.0.1"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Intrasellar aneurysms are rare lesions that often mimic pituitary tumors, potentially resulting in catastrophic outcomes if they are not appropriately recognized. The authors aimed to characterize the clinical and anatomical details of this poorly defined entity in the modern era of neuroimaging and open\/endovascular neurosurgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A PubMed literature review was conducted to identify all studies reporting noniatrogenic aneurysms with intrasellar extension, as confirmed by CT or MR imaging and angiography. Clinical, anatomical, and treatment characteristics were analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Thirty-one studies reporting 40 cases of intrasellar aneurysms were identified. Six patients (15%) presented with aneurysmal rupture. Patients with unruptured aneurysms presented with the following signs and symptoms: headache (61%), visual field cuts\/decreased visual acuity (61%), endocrinopathy (57%), symptomatic hyponatremia (21%), and cranial nerve paresis (other than optic nerve) (18%). The most common endocrine abnormalities were hyperprolactinemia and hypogonadism. Eight aneurysms (20%) were diagnosed in conjunction with a pituitary adenoma. Aneurysms could be categorized into 2 primary anatomical groups as follows: 1) cavernous\/clinoid segment internal carotid artery (ICA) (infradiaphragmatic) aneurysms with medial extension into the sella; and 2) suprasellar (supradiaphragmatic) aneurysms originating from the ophthalmic segment of the ICA or from the anterior communicating artery, with inferomedial extension into the sella. The mean diameters of infradiaphragmatic and supradiaphragmatic aneurysms were 14.5 and 21.8 mm, respectively. Infradiaphragmatic aneurysms were much more likely to present with endocrinopathy, whereas supradiaphragmatic ones presented more commonly with visual disturbances. Aneurysms with infradiaphragmatic growth were generally treated using either endovascular techniques or surgical trapping and bypass, while supradiaphragmatic aneurysms were more often treated by surgical clipping.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Aneurysms with intrasellar extension typically present due to mass effect on surrounding structures, and they can be classified as infradiaphragmatic cavernous or clinoid segment ICA aneurysms, or supradiaphragmatic ophthalmic ICA or anterior communicating artery aneurysms. Varying approaches exist for treating these complex aneurysms, and intervention strategies depend substantially on the anatomical subtype.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.9.jns11380","type":"journal-article","created":{"date-parts":[[2011,11,4]],"date-time":"2011-11-04T13:59:15Z","timestamp":1320415155000},"page":"164-178","source":"Crossref","is-referenced-by-count":56,"title":["Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics"],"prefix":"10.3171","volume":"116","author":[{"given":"Brian W.","family":"Hanak","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram V.","family":"Nayar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Georgetown University Hospital, Washington, DC; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Thiex","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur L.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Medical School at Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11380","series-title":"Neurochirurgia (Stuttg)","first-page":"177","article-title":"Association between intracranial aneurysms and pituitary adenomas. Aetiopathogenetic hypotheses","volume":"30","author":"Acqui","year":"1987"},{"key":"b2-jns11380","series-title":"Neurosurgery","first-page":"564","article-title":"Partially thrombosed aneurysm presenting as the sudden onset of bitemporal hemianopsia","volume":"22","author":"Aoki","year":"1988"},{"key":"b3-jns11380","series-title":"Eur Neurol","first-page":"321","article-title":"Intrasellar aneurysms simulating hypophyseal tumors","volume":"3","author":"Arseni","year":"1970"},{"key":"b4-jns11380","series-title":"Ital J Neurol Sci","first-page":"369","article-title":"A further case of giant intrasellar carotid aneurysm mimicking a pituitary adenoma: the relevance of a multivariate approach in differential diagnosis","volume":"15","author":"Barontini","year":"1994"},{"key":"b5-jns11380","series-title":"Acta Neurochir Suppl (Wien)","first-page":"49","article-title":"Italian cooperative study on giant intracranial aneurysms: 1. 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A clinical and anatomical analysis","volume":"72","author":"Day","year":"1990"},{"key":"b18-jns11380","series-title":"Clin Neurosurg","first-page":"256","article-title":"Clinicoanatomic features of supraclinoid aneurysms","volume":"36","author":"Day","year":"1990"},{"key":"b19-jns11380","series-title":"J Neurosurg","first-page":"713","article-title":"Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas","volume":"64","author":"Ebersold","year":"1986"},{"key":"b20-jns11380","series-title":"Clin Investig","first-page":"302","article-title":"Giant intrasellar aneurysm presenting with panhypopituitarism and subarachnoid hemorrhage: case report and literature review","volume":"72","author":"Fern\u00e1ndez-Real","year":"1994"},{"key":"b21-jns11380","series-title":"Neurosurgery","first-page":"1115","article-title":"Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device","volume":"62","author":"Fiorella","year":"2008"},{"key":"b22-jns11380","series-title":"J Neurosurg Sci","first-page":"41","article-title":"Diagnosis and treatment of pituitary adenoma with adjacent carotid artery aneurysm","volume":"35","author":"Fujiwara","year":"1991"},{"key":"b23-jns11380","series-title":"AJNR Am J Neuroradiol","first-page":"2014","article-title":"Migrating subdural hematoma without subarachnoid hemorrhage in the case of a patient with a ruptured aneurysm in the intrasellar anterior communicating artery","volume":"28","author":"Gilad","year":"2007"},{"key":"b24-jns11380","series-title":"Arq Neuropsiquiatr","first-page":"158","article-title":"Hypopituitarism and amenorrhea-galactorrhea syndrome caused by thrombosis of both internal carotid artery and giant intrasellar aneurysm: case report","volume":"62","author":"Gondim","year":"2004"},{"key":"b25-jns11380","series-title":"Clin Endocrinol (Oxf)","first-page":"763","article-title":"Postoperative surveillance of clinically nonfunctioning pituitary macroadenomas: markers of tumour quiescence and regrowth","volume":"58","author":"Greenman","year":"2003"},{"key":"b26-jns11380","series-title":"J Neurosurg","first-page":"968","article-title":"Large ophthalmic segment aneurysms with anterior optic pathway compression: assessment of anatomical and visual outcomes after endosaccular coil therapy","volume":"106","author":"Heran","year":"2007"},{"key":"b27-jns11380","series-title":"Mayo Clin Proc","first-page":"789","article-title":"Hypopituitarism caused by intrasellar aneurysms","volume":"76","author":"Heshmati","year":"2001"},{"key":"b28-jns11380","series-title":"Surg Neurol","first-page":"108","article-title":"A growth-hormone\u2014producing pituitary adenoma and an internal carotid artery aneurysm","volume":"18","author":"Hori","year":"1982"},{"key":"b29-jns11380","series-title":"J Neuropathol Exp Neurol","first-page":"409","article-title":"A systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital, 1914 to 1956","volume":"17","author":"Housepian","year":"1958"},{"key":"b30-jns11380","series-title":"Neurol Med Chir (Tokyo)","first-page":"654","article-title":"Fatal epistaxis caused by rupture of an intratumoral aneurysm enclosed by a large prolactinoma\u2014case report","volume":"38","author":"Imamura","year":"1998"},{"key":"b31-jns11380","series-title":"J Neurol Neurosurg Psychiatry","first-page":"972","article-title":"Coincidental aneurysms with tumours of pituitary origin","volume":"41","author":"Jakubowski","year":"1978"},{"key":"b32-jns11380","series-title":"South Med J","first-page":"741","article-title":"Rupture of a parasellar aneurysm with a coexisting pituitary tumor","volume":"71","author":"Jordan","year":"1978"},{"key":"b33-jns11380","series-title":"J Endocrinol Invest","first-page":"975","article-title":"Giant aneurysms of the sellar region simulating pituitary adenomas: a diagnosis to be considered","volume":"14","author":"Kayath","year":"1991"},{"key":"b34-jns11380","series-title":"Exp Clin Endocrinol Diabetes","first-page":"551","article-title":"Giant intrasellar carotid aneurysm\u2014an unusual cause of panhypopituitarism","volume":"113","author":"Klose","year":"2005"},{"key":"b35-jns11380","series-title":"J Clin Neuroophthalmol","first-page":"169","article-title":"Carotid artery aneurysm simulating pituitary adenoma","volume":"2","author":"Krauss","year":"1982"},{"key":"b36-jns11380","series-title":"J Clin Endocrinol Metab","first-page":"4616","article-title":"Hypopituitarism associated with a giant aneurysm of the internal carotid artery","volume":"93","author":"Lawson","year":"2008"},{"key":"b37-jns11380","series-title":"Med Health R I","first-page":"52","article-title":"Severe hyponatremia caused by an instrasellar carotid artery aneurysm","volume":"86","author":"Lee","year":"2003"},{"key":"b38-jns11380","series-title":"Mayo Clin Proc","first-page":"532","article-title":"Intrasellar aneurysm and pituitary adenoma: report of a case","volume":"46","author":"Lippman","year":"1971"},{"key":"b39-jns11380","series-title":"Eur J Neurol","first-page":"98","article-title":"A potential catastrophic trap: an unusually presenting sellar lesion","volume":"15","author":"Locatelli","year":"2008"},{"key":"b40-jns11380","series-title":"Neurosurgery","first-page":"632","article-title":"Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience","volume":"64","author":"Lylyk","year":"2009"},{"key":"b41-jns11380","series-title":"Neuroradiology","first-page":"177","article-title":"Radiological differentiation of intrasellar aneurysms from pituitary tumours","volume":"21","author":"Macpherson","year":"1981"},{"key":"b42-jns11380","series-title":"Surg Neurol","first-page":"38","article-title":"Coincidental pituitary adenoma and cerebral aneurysm with pathological findings","volume":"19","author":"Mangiardi","year":"1983"},{"key":"b43-jns11380","series-title":"Postgrad Med J","first-page":"285","article-title":"Bilateral carotid aneurysms unmasked by severe hypopituitarism","volume":"67","author":"Michils","year":"1991"},{"key":"b44-jns11380","series-title":"J Endocrinol Invest","first-page":"450","article-title":"Case report of hypopituitarism with suspected syndrome of inappropriate VP secretion (SIADH) due to a large aneurysm of the internal carotid in the sellar region","volume":"26","author":"Miljic","year":"2003"},{"key":"b45-jns11380","series-title":"Surg Neurol","first-page":"163","article-title":"Bilateral intracavernous carotid aneurysms mimicking a prolactin-secreting pituitary tumor","volume":"19","author":"Mindel","year":"1983"},{"key":"b46-jns11380","series-title":"Surg Neurol","first-page":"69","article-title":"Anterior communicating artery aneurysm in the sella turcica: case report","volume":"62","author":"Murai","year":"2004"},{"key":"b47-jns11380","series-title":"J Neurosurg","first-page":"217","article-title":"The incidence and treatment of asymptomatic, unruptured cerebral aneurysms","volume":"80","author":"Nakagawa","year":"1994"},{"key":"b48-jns11380","series-title":"Headache","first-page":"527","article-title":"A late \u2018migraine\u2019: the only symptom of an intrasellar aneurysm","volume":"37","author":"Narbone","year":"1997"},{"key":"b49-jns11380","series-title":"Can J Neurol Sci","first-page":"70","article-title":"Hypopituitarism resulting from an intrasellar carotid aneurysm","volume":"13","author":"Ooi","year":"1986"},{"key":"b50-jns11380","series-title":"Neurosurg Rev","first-page":"13","article-title":"Incidence of intracranial aneurysm associated with pituitary adenoma","volume":"20","author":"Pant","year":"1997"},{"key":"b51-jns11380","series-title":"Br J Neurosurg","first-page":"590","article-title":"Spontaneous thrombosis of a giant internal carotid aneurysm in a patient who presented with hypopituitarism","volume":"16","author":"Ray","year":"2002"},{"key":"b52-jns11380","series-title":"AJNR Am J Neuroradiol","first-page":"980","article-title":"Intrasellar rupture of a paraclinoid aneurysm with subarachnoid hemorrhage: usefulness of MR imaging in diagnosis","volume":"29","author":"Ribeiro","year":"2008"},{"key":"b53-jns11380","series-title":"J Clin Neurosci","first-page":"476","article-title":"Carotid cavernous aneurysm presenting as pituitary apoplexy","volume":"13","author":"Romano","year":"2006"},{"key":"b54-jns11380","series-title":"J Comput Assist Tomogr","first-page":"1033","article-title":"Kissing intrasellar carotid arteries in acromegaly: CT demonstration","volume":"10","author":"Sacher","year":"1986"},{"key":"b55-jns11380","series-title":"J Neurosurg","first-page":"557","article-title":"Intrasellar aneurysm and a growth hormone-secreting pituitary macroadenoma. Case report","volume":"100","author":"Sade","year":"2004"},{"key":"b56-jns11380","series-title":"Arq Neuropsiquiatr","first-page":"99","article-title":"Intrasellar internal carotid aneurysm coexisting with GH-secreting pituitary adenoma in an acromegalic patient","volume":"66","author":"Seda","year":"2008"},{"key":"b57-jns11380","series-title":"Korean J Ophthalmol","first-page":"124","article-title":"Junctional scotoma in giant cerebral aneurysm","volume":"16","author":"Shin","year":"2002"},{"key":"b58-jns11380","series-title":"Pituitary","first-page":"307","article-title":"A case of macroprolactinoma encasing an internal carotid artery aneurysm, presenting as pituitary apoplexy","volume":"11","author":"Soni","year":"2008"},{"key":"b59-jns11380","series-title":"Stroke","first-page":"567","article-title":"Pituitary apoplexy caused by ruptured internal carotid artery aneurysm","volume":"32","author":"Suzuki","year":"2001"},{"key":"b60-jns11380","series-title":"AJNR Am J Neuroradiol","first-page":"230","article-title":"The safety of dedicated-team catheter-based diagnostic cerebral angiography in the era of advanced noninvasive imaging","volume":"31","author":"Thiex","year":"2010"},{"key":"b61-jns11380","series-title":"Neurosurgery","first-page":"E1202","article-title":"Bilateral internal carotid artery aneurysm simulating pituitary apoplexy: case report","volume":"65","author":"Torres","year":"2009"},{"key":"b62-jns11380","series-title":"Surg Neurol","first-page":"67","article-title":"Rupture of anterior communicating artery aneurysm during transsphenoidal surgery for pituitary adenoma","volume":"20","author":"Tsuchida","year":"1983"},{"key":"b63-jns11380","series-title":"Brain","first-page":"50","article-title":"Intracranial aneurysms","volume":"41","author":"Turnbull","year":"1918"},{"key":"b64-jns11380","series-title":"Surg Neurol","first-page":"503","article-title":"Association of cerebral aneurysm with pituitary adenoma","volume":"12","author":"Wakai","year":"1979"},{"key":"b65-jns11380","series-title":"Neurosurgery","first-page":"585","article-title":"Pituitary tumors and aneurysms: case report and review of the literature","volume":"30","author":"Weir","year":"1992"},{"key":"b66-jns11380","series-title":"J Neurosurg","first-page":"34","article-title":"Intrasellar aneurysms simulating hypophyseal tumours","volume":"18","author":"White","year":"1961"},{"key":"b67-jns11380","series-title":"J Clin Neurosci","first-page":"477","article-title":"Cavernous aneurysm and pituitary adenoma: management of dual intrasellar lesions","volume":"12","author":"Yang","year":"2005"},{"key":"b68-jns11380","series-title":"J Neurosurg","first-page":"350","article-title":"Endonasal transsphenoidal approach for pituitary adenomas and other sellar lesions: an assessment of efficacy, safety, and patient impressions","volume":"98","author":"Zada","year":"2003"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/1\/article-p164.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/1\/article-p164.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/1\/article-p164.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:27:21Z","timestamp":1679880441000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/1\/article-p164.xml"}},"subtitle":["A review"],"short-title":[],"issued":{"date-parts":[[2012,1]]},"references-count":68,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2011.9.jns11380","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1]]}}}