Question: A 45 year old acromegalic male is undergoing transsphenoidal resection of a growth hormone secreting pituitary adenoma. Your colleague is performing the approach and notes significant erythema of the nasal mucosa and brisk bleeding in spite of normotension and vasoconstrictor application. The intersinus septum is noted to be very firm and in spite of using a cutting forceps, cracks, and the right carotid artery is torn. Pledgets are applied quickly and transfusion is initiated. In spite of pledget application the patient continues to bleed and the sphenoid is aggressively packed with gauze. Assuming no pre-existing cerebrovascular disease, what is this patient's risk of stroke? [Answer will be posted with next week's new question]

Answer to last week's question, "It's the Pits" (June 19, 2017)

Beckwith-Wiedemann syndrome