Transsphenoidal 

Surgical approach to the sella turcica (location of the pituitary gland) as well as the para- (alongside) and supra- (above) sellar regions.

Sphenoid sinus - anatomy

Pituitary gland - anatomy

Transsphenoidal craniotomy - procedure

Transsphenoidal craniotomy - risks complications transsphenoidal

Skull base Specialty Center

Transsphenoidal surgery hazards:  Important nearby neural and vascular structures and the consequences of injury to them.

Important vascular and neural structures vulnerable to injury by tearing or cutting (surgical), compression,by a mass (tumor or hematoma), or shearing and crush (trauma) encountered during transsphenoidal surgery.

Injury to the carotid artery can result from surgical trauma or from a mass that grows around (and sometimes into) it.   Carotid occlusion can result from compression by a mass or from vasospasm that closes down the artery (reduces the lumen diameter).

The optic chiasm is located at the base of the brain in the midline.  It is the posterior extension (and termination) of the optic nerves.  The optic chiasm is sometimes injured during pituitary surgery by curved or angled surgical instruments that reach up into the sella turcica searching for tumor.  

If injury to the carotid causes it to spasm, ischemia of brain  downstream could look clinically (symptoms and signs) like a stroke.  If the vasospasm resolves and flow through the carotid is  restored there is a possibility for recovery of neural function as long as brain tissue did not die while ischemic.

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