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Case Reports |

Intracranial Aneurysm Causing Panhypopituitarism, Blindness, Seizures, and Dementia

SID GILMAN, M.D.; LEWIS E. BRAVERMAN, M.D.; ARNOLD STARR, M.D.; SIMON HORENSTEIN, M.D.; and JEREMIAH G. TILLES, M.D.
Ann Intern Med. 1962;57(4):639-646. doi:10.7326/0003-4819-57-4-639
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Intracranial aneurysms of the sellar region which compress the optic nerves, chiasm, or tracts may simulate pituitary tumors by causing visual field defects (1-3). The presumed rarity of hypopituitarism in association with these aneurysms previously served as one clinical means of distinguishing aneurysm from tumor (4). Paralleling advances in the assessment of pituitary function, however, an increasing number of reports relate pituitary failure to aneurysms of the sellar region (1, 3, 5-17). As the true incidence of hypopituitarism secondary to aneurysm becomes apparent, the value of pituitary failure as a sign of tumor rather than aneurysm diminishes.

FIGURE. 1. Right visual field plotted on tangent screen using a 4 mm white object at 1 m in 1942 (A), 1944 (B), 1953 (C), and 1961 (D).

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