Cavernous Internal Carotid Artery Aneurysm After Radiotherapy Presenting With External Ophthalmoplegia

Abstract

Cranial radiotherapy could cause several types of vasculopathies, which include atherosclerotic occlusive diseases, moyamoya disease, and aneurysm formation. To our knowledge, radiation-induced aneurysms of the internal carotid artery (ICA) are extremely rare. Here, we report a 68-year-old woman who presented with external ophthalmoplegia caused by radiotherapy after the transsphenoidal surgery for metastastic tumor of the clivus region, and the angiography demonstrated a giant aneurysm of the cavernous ICA. After the ICA ligation, the patient recovered well without brain ischemia with a 6-month-long follow-up. The present case is extremely rare with external opthalmoplegia caused by the giant cavernous ICA aneurysm, and the radiotherapy after transsphenoidal surgery might have been critical in the formation of the aneurysm.

Unruptured anterior Inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: Case report and literature review

“…The average age of VS patients diagnosed with RRA was 63.1 years, and the average interval from radiotherapy initiation to RRA diagnosis was about 10.4 years. Wu et al carried out a meta-analysis of 58 cases with RRAs in various intracranial sites, finding that men were more susceptible to RRA than women at an age below 52 years (the age at the time of radiotherapy), while women became more susceptible at an older age ( 15 ). This is consistent with the results from our literature review about the onset age of VS.…”

“…In a series of 58 patients with radiation-related intracranial aneurysm, 74.1% presented with rupture ( 15 ). Pesce et al reviewed 67 cases of radiation-related intracranial aneurysm, finding that the RRAs in the posterior cranial fossa were more prone to rupture ( 18 ).…”

Internal carotid artery blister aneurysm rupture: a unifying diagnosis for massive epistaxis and unilateral embolic strokes

“…ICA aneurysms have been reported as a rare complication of transsphenoidal surgery and radiotherapy 1–3. Blister aneurysms are even more uncommon, particularly in the petrous segment, accounting for 0.9% of all ICA aneurysms 4.…”