Pituitary insufficiency from large unruptured supraclinoid internal carotid artery aneurysm.

A 59-year-old female presented with headache and fatigue. Angiography revealed a giant superior hypophyseal aneurysm with intrasellar extension. Serum endocrine panel demonstrated pituitary insufficiency. The aneurysm was treated with a pipeline flow-diverting stent and the hypopituitarism was treated with hormone replacement. Pituitary insufficiency from aneurysmal compression is extremely rare.