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V020: MULTIDISCIPLINARY MANAGEMENT OF ICA INJURY IN ENDOSCOPIC ENDONASAL SURGERY
Akshaya Raman; Ali A Alattar, MD; Paul A Gardner, MD; Carl H Snyderman, MD; University of Pittsburgh Medical Center

This video presents endoscopic endonasal resection of a giant prolactinoma with cavernous sinus invasion. Intraoperatively, arterial injury to the parasellar ICA caused brisk hemorrhage, controlled with tamponade, cottonoid, and eventual endovascular pipeline reconstruction. Despite transient SSEP decline, the patient remained neurologically intact with no infarct. Postoperatively, prolactin levels decreased significantly, permitting dose reduction of cabergoline. The case highlights technical nuances of cavernous sinus surgery, multidisciplinary coordination, and management of intraoperative ICA injury.

 

 

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