[An operated case of giant pituitary XXXX (author's transl)].

@entity1 @entity2656 @entity1640 @entity5 @entity75 @entity3538 @entity128 @entity6455 @entity977 @entity652
A case of giant pituitary @entity652 was reported. The @entity1 was a 47-year-old @entity1 with visual disturbance. CT scan revealed the huge @entity5 , about 6 cm in diameter, at the midportion over the sella turcica, extending to the frontal, temporal, posterior and @entity1640 region. Total resection of the @entity5 was successfully carried out and the difficult post-operative complications were overcome. In this paper we mainly discussed the operative procedure for @entity977 , which usually involve the main cerebral arteries, i.e., A1 and A2 portion of the anterior cerebral artery (ACA), anterior communicating artery (ACOMA) and @entity3538 (ICA). We used to expose the internal carotid artery at the neck for the temporary occlusion prior to craniotomy. Prolongation of the temporary occlusion time is achieved by intravenous administration of 800 ml-20% @entity2656 solution. After bifrontal craniotomy, we approach the @entity5 interhemispherically and expose the A2 portion of ACA. Then anterior communicating artery, A1 portion of ACA and @entity6455 are exposed as the @entity5 is extirpated. Under the bifrontal craniotomy, as we separate bilateral Sylvian fissure and interhemisphere, we can get the wide operative field and we can also approach the @entity5 from various direction. Therefore, even the @entity5 is huge, it is possible to remove the @entity5 without @entity75 , vessel and @entity128 .
