Download PDF
J Neurol Surg A Cent Eur Neurosurg 2024; 85(01): 100-104
DOI: 10.1055/s-0042-1748773
Case Report

The Clinical Relevance of the Thalamogeniculate Arteries in Endoscopic Endonasal Surgery for Giant Pituitary Adenomas in the Interpeduncular Fossa

Martin Pilonieta
1   CALDAS, Santa Sofia de Caldas Academic State Hospital, Manizales, Colombia
,
Paula Pérez
1   CALDAS, Santa Sofia de Caldas Academic State Hospital, Manizales, Colombia
,
Daniel M. Prevedello 
2   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Bilateral thalamic stroke is usually due to compromised artery of Percheron, an anatomical variation of the vascular supply of the thalamus. The stroke in this area is very uncommon, and is mainly due to top of the basilar syndrome. Other causes are extremely rare. We describe the case of a patient with a pituitary adenoma who underwent surgery and later presented with a bilateral thalamic infarct, suggesting compromise of the artery of Percheron. This would be the third case published in the literature about this complication. We present a literature review about the vascular supply of the thalamus, the artery of Percheron, and its involvement in pituitary surgery.

Keywords

stroke - thalamus - thalamic supply - artery of percheron


Publication History

Received: 07 June 2021

Accepted: 07 March 2022

Article published online:
27 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Rhoton Jr AL. The cerebrum. Anatomy. Neurosurgery 2007;61(1, Suppl):37–118, discussion 118–119
    PubMedGoogle Scholar
  • 2 Matheus MG, Castillo M. Imaging of acute bilateral paramedian thalamic and mesencephalic infarcts. AJNR Am J Neuroradiol 2003; 24 (10) 2005-2008
    PubMedGoogle Scholar
  • 3 Percheron G. The anatomy of the arterial supply of the human thalamus and its use for the interpretation of the thalamic vascular pathology. Z Neurol 1973; 205 (01) 1-13
    PubMedGoogle Scholar
  • 4 Bogousslavsky J, Miklossy J, Deruaz JP, Regli F, Assal G. Unilateral left paramedian infarction of thalamus and midbrain: a clinico-pathological study. J Neurol Neurosurg Psychiatry 1986; 49 (06) 686-694
    CrossrefPubMedGoogle Scholar
  • 5 Schmahmann JD. Vascular syndromes of the thalamus. Stroke 2003; 34 (09) 2264-2278
    CrossrefPubMedGoogle Scholar
  • 6 Kocaeli H, Yilmazlar S, Kuytu T, Korfali E. The artery of Percheron revisited: a cadaveric anatomical study. Acta Neurochir (Wien) 2013; 155 (03) 533-539
    CrossrefPubMedGoogle Scholar
  • 7 Khanni JL, Casale JA, Koek AY, Espinosa Del Pozo PH, Espinosa PS. Artery of Percheron infarct: an acute diagnostic challenge with a spectrum of clinical presentations. Cureus 2018; 10 (09) e3276
    PubMedGoogle Scholar
  • 8 Lazzaro NA, Wright B, Castillo M. et al. Artery of Percheron infarction: imaging patterns and clinical spectrum. AJNR Am J Neuroradiol 2010; 31 (07) 1283-1289
    CrossrefPubMedGoogle Scholar
  • 9 Uz A. Variations in the origin of the thalamoperforating arteries. J Clin Neurosci 2007; 14 (02) 134-137
    CrossrefPubMedGoogle Scholar
  • 10 Pedroza A, Dujovny M, Ausman JI. et al. Microvascular anatomy of the interpeduncular fossa. J Neurosurg 1986; 64 (03) 484-493
    CrossrefPubMedGoogle Scholar
  • 11 Lang J, Brunner FX. Uber die Rami centrales der Aa. cerebri anterior und media. Gegenbaurs Morphol Jahrb 1978; 124 (03) 364-374
    PubMedGoogle Scholar
  • 12 Park SQ, Bae HG, Yoon SM, Shim JJ, Yun IG, Choi SK. Morphological characteristics of the thalamoperforating arteries. J Korean Neurosurg Soc 2010; a 47 (01) 36-41
    CrossrefPubMedGoogle Scholar
  • 13 Kaya AH, Dagcinar A, Ulu MO. et al. The perforating branches of the P1 segment of the posterior cerebral artery. J Clin Neurosci 2010; 17 (01) 80-84
    CrossrefPubMedGoogle Scholar
  • 14 Caruso P, Manganotti P, Moretti R. Complex neurological symptoms in bilateral thalamic stroke due to Percheron artery occlusion. Vasc Health Risk Manag 2016; b 13: 11-14
    CrossrefPubMedGoogle Scholar
  • 15 Motegi H, Terasaka S, Shiraishi H, Houkin K. Thalamic arteriovenous malformation fed by the artery of Percheron originating from the contralateral posterior cerebral artery in a child. Childs Nerv Syst 2014; 30 (07) 1313-1315
    CrossrefPubMedGoogle Scholar
  • 16 Lin PC, Lee CW, Liu HM, Xiao FR. Acute infarction in the artery of Percheron distribution during cerebral angiography: a case report and literature review. J Radiol Case Rep 2018; 12 (07) 1-9
    CrossrefPubMedGoogle Scholar
  • 17 Rangel-Castilla L, Gasco J, Thompson B, Salinas P. Bilateral paramedian thalamic and mesencephalic infarcts after basilar tip aneurysm coiling: role of the artery of Percheron. Neurocirugia (Astur) 2009; 20 (03) 288-293
    CrossrefPubMedGoogle Scholar
  • 18 Sudhakar N, Ray A, Vafidis JA. Complications after trans-sphenoidal surgery: our experience and a review of the literature. Br J Neurosurg 2004; 18 (05) 507-512
    CrossrefPubMedGoogle Scholar
  • 19 Reddy K, Fewer D, West M. Complications of the transsphenoidal approach to sellar lesions. Can J Neurol Sci 1991; 18 (04) 463-466
    CrossrefPubMedGoogle Scholar
  • 20 Kuroyanagi T, Kobayashi S, Takemae T, Kobayashi S. Subarachnoid hemorrhage, midbrain hemorrhage and thalamic infarction following transsphenoidal removal of a pituitary adenoma. A case report. Neurosurg Rev 1994; 17 (02) 161-165
    CrossrefPubMedGoogle Scholar
  • 21 Yano S, Hide T, Shinojima N. Efficacy and complications of endoscopic skull base surgery for giant pituitary adenomas. World Neurosurg 2017; 99: 533-542
    CrossrefPubMedGoogle Scholar
  • 22 Sankar T, Souster J, Steinke DE. Bilateral thalamic infarction following transsphenoidal surgery. Can J Neurol Sci 2008; 35 (04) 522-525
    CrossrefPubMedGoogle Scholar
  • 23 Aryan S, Thakar S, Hegde AS. Artery of Percheron infarction after endoscopic pituitary surgery. Acta Neurochir (Wien) 2016; 158 (10) 1973-1975
    CrossrefPubMedGoogle Scholar
  • 24 Mortini P, Barzaghi R, Losa M, Boari N, Giovanelli M. Surgical treatment of giant pituitary adenomas: strategies and results in a series of 95 consecutive patients. Neurosurgery 2007; 60 (06) 993-1002 , discussion 1003–1004
    CrossrefPubMedGoogle Scholar
  • 25 Elshazly K, Kshettry VR, Farrell CJ, Nyquist G, Rosen M, Evans JJ. Clinical outcomes after endoscopic endonasal resection of giant pituitary adenomas. World Neurosurg 2018; 114: e447-e456
    CrossrefPubMedGoogle Scholar
  • 26 Kuga D, Toda M, Ozawa H, Ogawa K, Yoshida K. Endoscopic endonasal approach combined with a simultaneous transcranial approach for giant pituitary tumors. World Neurosurg 2019; 121: 173-179
    CrossrefPubMedGoogle Scholar
  • 27 Fallah N, Taghvaei M, Sadaghiani S, Sadrhosseini SM, Esfahanian F, Zeinalizadeh M. Surgical outcome of endoscopic endonasal surgery of large and giant pituitary adenomas: an institutional experience from the Middle East. World Neurosurg 2019; 132: e802-e811
    CrossrefPubMedGoogle Scholar
  • 28 Gondim JA, Almeida JP, Albuquerque LA, Gomes EF, Schops M. Giant pituitary adenomas: surgical outcomes of 50 cases operated on by the endonasal endoscopic approach. World Neurosurg 2014; 82 (1–2): e281-e290
    CrossrefPubMedGoogle Scholar
  • 29 Billings M, Dahlin R, Zampella B, Sweiss R, Lawandy S, Miulli D. Conditions associated with giant pituitary tumors at the time of surgery effecting outcome morbidity and mortality. Surg Neurol Int 2019; 10: 92
    CrossrefPubMedGoogle Scholar
  • 30 Koutourousiou M, Gardner PA, Fernandez-Miranda JC, Paluzzi A, Wang EW, Snyderman CH. Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations. J Neurosurg 2013; 118 (03) 621-631
    CrossrefPubMedGoogle Scholar
  • 31 Kuo CH, Yen YS, Wu JC. et al. Primary endoscopic transnasal transsphenoidal surgery for giant pituitary adenoma. World Neurosurg 2016; a 91: 121-128
    CrossrefPubMedGoogle Scholar
  • 32 Constantino ER, Leal R, Ferreira CC, Acioly MA, Landeiro JA. Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications. Arq Neuropsiquiatr 2016; 74 (05) 388-395
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Cusimano MD, Kan P, Nassiri F. et al. Outcomes of surgically treated giant pituitary tumours. Can J Neurol Sci 2012; a 39 (04) 446-457
    CrossrefPubMedGoogle Scholar
  • 34 Juraschka K, Khan OH, Godoy BL. et al. Endoscopic endonasal transsphenoidal approach to large and giant pituitary adenomas: institutional experience and predictors of extent of resection. J Neurosurg 2014; 121 (01) 75-83
    CrossrefPubMedGoogle Scholar