{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T13:21:59Z","timestamp":1769865719191,"version":"3.49.0"},"reference-count":76,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,9,29]]},"abstract":"\n BACKGROUND<\/jats:title>\n Cerebral vasospasm is a rare yet serious complication of transsphenoidal surgery (TSS). While its etiology is incompletely understood, early detection is critical for proper management.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors report the case of a 35-year-old female with acromegaly who underwent TSS for resection of somatotroph macroadenoma. The adenoma was completely removed with its pseudocapsule, and no CSF leakage was encountered. Postoperative imaging was notable for blood products in the interpeduncular cistern. A week after surgery, she presented to the clinic with dysarthria, right-sided ataxia, and right eye exotropia. CT angiography identified vasospasm at the basilar tip, with subsequent MRI demonstrating an infarction of the midbrain. The patient was admitted, underwent aggressive fluid resuscitation, and then discharged after vitals had stabilized and ambulation and speech had improved. Incomplete right eye convergence resolved by the 3-month follow-up.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The authors present a rare case of cerebral vasospasm following transsphenoidal resection of a pituitary macroadenoma and discuss the effect on midbrain tracts involved in vergence.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25453<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25453","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:02:21Z","timestamp":1759795341000},"source":"Crossref","is-referenced-by-count":0,"title":["Basilar artery vasospasm following transsphenoidal resection of recurrent pituitary macroadenoma: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8117-5744","authenticated-orcid":true,"given":"Luke R.","family":"Jackson","sequence":"first","affiliation":[{"name":"Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua Miles","family":"Diamond","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9349-4756","authenticated-orcid":true,"given":"Prashant","family":"Chittiboina","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland"},{"name":"Neurosurgery Unit for Pituitary and Inheritable Diseases, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"World Neurosurg","first-page":"29","article-title":"Clinical vasospasm after an extended endoscopic endonasal approach for recurrent pituitary adenoma: illustrative case and systematic review of the literature","volume":"128","author":"Suero Molina","year":"2019","unstructured":"Suero Molina EDi Somma AStummer WBriganti FCavallo LM.Clinical vasospasm after an extended endoscopic endonasal approach for recurrent pituitary adenoma: illustrative case and systematic review of the literature. World Neurosurg. 2019;128:29-36."},{"key":"bib2","series-title":"World Neurosurg","first-page":"233","article-title":"Delayed complications after transsphenoidal surgery for pituitary adenomas","volume":"109","author":"Alzhrani","year":"2018","unstructured":"Alzhrani GSivakumar WPark MSTaussky PCouldwell WT.Delayed complications after transsphenoidal surgery for pituitary adenomas. World Neurosurg. 2018;109:233-241."},{"issue":"4","key":"bib3","series-title":"J Craniofac Surg","first-page":"988","article-title":"Cerebral vasospasm following transsphenoidal hypophysectomy in the treatment of lymphocytic hypophysitis","volume":"27","author":"Karimnejad","year":"2016","unstructured":"Karimnejad KSweeney JMAntisdel JL.Cerebral vasospasm following transsphenoidal hypophysectomy in the treatment of lymphocytic hypophysitis. J Craniofac Surg. 2016;27(4):988-991."},{"issue":"6","key":"bib4","series-title":"Can J Neurol Sci","first-page":"767","article-title":"Vasospasm post pituitary surgery: systematic review and 3 case presentations","volume":"39","author":"Mansouri","year":"2012","unstructured":"Mansouri AFallah ACusimano MDDas S.Vasospasm post pituitary surgery: systematic review and 3 case presentations. Can J Neurol Sci. 2012;39(6):767-773."},{"issue":"3","key":"bib5","series-title":"J Neurol Stroke","article-title":"Cerebral vasospasms following endoscopic endonasal surgery for pituitary adenoma resection in the absence of post-operative subarachnoid hemorrhage","volume":"4","author":"Koutourousiou","year":"2016","unstructured":"Koutourousiou M.Cerebral vasospasms following endoscopic endonasal surgery for pituitary adenoma resection in the absence of post-operative subarachnoid hemorrhage. J Neurol Stroke. 2016;4(3)."},{"issue":"5","key":"bib6","series-title":"Cureus","first-page":"e8171","article-title":"Symptomatic cerebral vasospasm after transsphenoidal tumor resection: two case reports and systematic literature review","volume":"12","author":"Budnick","year":"2020","unstructured":"Budnick HCTomlinson SSavage JCohen-Gadol A.Symptomatic cerebral vasospasm after transsphenoidal tumor resection: two case reports and systematic literature review. Cureus. 2020;12(5):e8171."},{"issue":"7","key":"bib7","series-title":"J Neurosurg Case Lessons","first-page":"CASE22349","article-title":"Cerebral vasospasm as a consequence of pituitary apoplexy: illustrative case","volume":"5","author":"Alsayadi","year":"2023","unstructured":"Alsayadi SOchoa-Sanchez RMoldovan IDAlkherayf F.Cerebral vasospasm as a consequence of pituitary apoplexy: illustrative case. J Neurosurg Case Lessons. 2023;5(7):CASE22349."},{"issue":"1","key":"bib8","series-title":"Sci Rep","first-page":"868","article-title":"A single-center prospective study evaluating the relationship of tumor consistency on remission in acromegaly patients","volume":"15","author":"Yilmaz","year":"2025","unstructured":"Yilmaz EOzturk SDUzuner AA single-center prospective study evaluating the relationship of tumor consistency on remission in acromegaly patients. Sci Rep. 2025;15(1):868."},{"issue":"4","key":"bib9","series-title":"Neurosurgery","first-page":"382","article-title":"Vasospasm after trans-sphenoidal hypophysectomy","volume":"7","author":"Camp","year":"1980","unstructured":"Camp PEPaxton HDBuchan GCGahbauer H.Vasospasm after trans-sphenoidal hypophysectomy. 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J Neurol Surg A Cent Eur Neurosurg. 2013;74(suppl 1):e119-e123."},{"issue":"3","key":"bib12","series-title":"J Neurosurg","first-page":"693","article-title":"Ophthalmoplegic complications in transsphenoidal pituitary surgery","volume":"133","author":"Florea","year":"2020","unstructured":"Florea SMGraillon TCuny TGras RBrue TDufour H.Ophthalmoplegic complications in transsphenoidal pituitary surgery. J Neurosurg. 2020;133(3):693-701."},{"issue":"2","key":"bib13","series-title":"J Neurosurg","first-page":"286","article-title":"Defining the \u201cedge of the envelope\u201d: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy","volume":"114","author":"Zada","year":"2011","unstructured":"Zada GDu RLaws ER.Defining the \u201cedge of the envelope\u201d: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy. 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Surg Neurol Int. 2024;15:201."},{"key":"bib18","series-title":"World Neurosurg","first-page":"236","article-title":"Endoscopic versus microscopic transsphenoidal surgery in the treatment of pituitary adenoma: a systematic review and meta-analysis","volume":"101","author":"Li","year":"2017","unstructured":"Li ALiu WCao PZheng YBu ZZhou T.Endoscopic versus microscopic transsphenoidal surgery in the treatment of pituitary adenoma: a systematic review and meta-analysis. World Neurosurg. 2017;101:236-246."},{"issue":"2","key":"bib19","series-title":"Neurol India","first-page":"606","article-title":"Management of postoperative vasospasm following endoscopic endonasal surgery for craniopharyngioma: report and review of literature","volume":"67","author":"Aggarwal","year":"2019","unstructured":"Aggarwal VNair PShivhare PKumar KSJayadevan ERNair S.Management of postoperative vasospasm following endoscopic endonasal surgery for craniopharyngioma: report and review of literature. 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