Background: Intracranial pseudoaneurysm after transsphenoidal surgery (TSS) is rare, particularly in the anterior communicating artery (AcomA). Case Description: A 47-year-old female underwent extended TSS for a giant pituitary adenoma with gross-total resection. She developed a subarachnoid hemorrhage on the night of surgery. Angiography revealed a ruptured AcomA pseudoaneurysm, which was successfully treated with coil embolization. The patient achieved good recovery (modified Rankin Scale 1). Conclusion: Early postoperative hemorrhage after TSS should prompt early vascular imaging, as timely endovascular treatment can be life-saving.
Shitara et al. (2026) studied this question.