Transcranial arterial coagulation with cardiac standstill after catastrophic frontopolar artery injury during endoscopic endonasal resection of tuberculum sellae meningioma: illustrative case

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Illustrative case highlights transcranial approach for arterial injury control during endonasal surgery, suggesting adaptive management is vital.

Patients experiencing massive hemorrhage during endoscopic endonasal skull base surgery may require rapid conversion to a transcranial approach to achieve hemostasis.
The reported case documented a significant blood loss of 5 liters in a patient undergoing endoscopic resection of a tuberculum sellae meningioma.
Transcranial coagulation was successfully performed using bipolar diathermy after initial endonasal control measures failed.
Timely recognition and a flexible management strategy are crucial for addressing catastrophic arterial injuries during endoscopic procedures.

Cayanong et al. (2025) studied this question.

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Illustrative case highlights transcranial approach for arterial injury control during endonasal surgery, suggesting adaptive management is vital.