# A Case of Pituitary Abscess and Multiple Cerebral Intracranial Aneurysms Related to Dental Caries

## TL;DR

A 60-year-old woman's dental infection led to a rare pituitary abscess and multiple cerebral aneurysms, highlighting the link between oral health and serious neurological complications.

## Contribution

The paper presents a rare case linking dental caries to pituitary abscess and infectious aneurysms, emphasizing the need for clinical suspicion in similar presentations.

## Key findings

- Dental caries may lead to pituitary abscess and multiple cerebral aneurysms.
- Infectious aneurysms were suspected in atypical locations due to E. coli infection.
- Poor oral hygiene and throat cultures confirmed a dental origin of the infection.

## Abstract

We report a rare case of a 60-year-old woman who initially presented with subarachnoid hemorrhage and was later diagnosed with a pituitary abscess 11 months after coil embolization. Poor oral hygiene and cultures positive for Escherichia coli (E. coli) from both the throat and pituitary abscess pus suggested that the infection had a dental origin. Because of the rarity of aneurysms with atypical morphology and location, the previously treated multiple intracranial aneurysms-including an anterior communicating artery aneurysm, a true posterior communicating artery aneurysm, and an anterior wall aneurysm of the internal carotid artery-were retrospectively suspected to be infectious. Because infectious aneurysms of the anterior communicating artery are exceptionally uncommon, we reviewed similar reported cases. This case highlights the potential for dental infections to cause serious central nervous system complications. Clinicians should maintain a high index of suspicion for pituitary abscess and the possibility of infectious aneurysms when encountering multiple aneurysms with atypical morphology or location, particularly in patients with poor oral hygiene or a suspected Rathke’s cleft cyst.