Intracavernous Carotid Aneurysms: A Clinical-Pathological Report

Barr, H. W. K.; Blackwood, W.; Meadows, S. P.

doi:10.1093/brain/94.4.607

Cited by 80 publications

(43 citation statements)

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“…Three of the four patients with SDH and one with SAH presented with ophthalmoplegia associated with pain or numbness in the first branch area of the trigeminal nerve. 2,4,8,14) These symptoms progressed rapidly during the 1 to 5 days before rupture. This time lag may reflect the difference between the period of rapid aneurysm growth and the period of aneurysm rupture followed by dural tearing.…”

Section: Discussionmentioning

confidence: 98%

“…1,2,4,5,8,14) Giant ICCA aneurysms rarely rupture into the cavernous sinus, possibly because the cavernous sinus space is obliterated by the aneurysm. In our case, angiography identified a carotid-cavernous fistula, suggesting that the sudden drop in the aneurysm wall pressure after rupture allowed some space to reappear in the cavernous sinus, resulting in the formation of the carotid-cavernous fistula.…”

Section: Discussionmentioning

confidence: 99%

“…3,[9][10][11][12][13] ICCA aneurysms may remain asymptomatic or manifest as symptoms caused by mass effects, such as symptoms of cranial nerves II, III, IV, V, or VI, depending on the direction of the aneurysm growth, 2,9) or rupture, resulting in carotid-cavernous fistula but not in subarachnoid hemorrhage (SAH). Therefore, this type of aneurysm is believed to be benign in nature.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, this type of aneurysm is believed to be benign in nature. 6,7) However, rupture may result in subdural hemorrhage (SDH), 1,2,4,14) SAH, 8) or intracerebral hemorrhage (ICH), 5) which are fatal in almost all cases.…”

Section: Introductionmentioning

confidence: 99%

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Intracerebral Hemorrhage Caused by Ruptured Intracavernous Carotid Artery Aneurysm -Case Report-

Iwaisako

Toyota

Ishihara

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 76-year-old woman presented with an enlarged right intracavernous carotid artery aneurysm first identified incidentally when she was hospitalized for thalamic hemorrhage. She was managed conservatively for 1 year, then suffered right total ophthalmoplegia associated with enlargement of the aneurysm. Two months later, she became comatose due to intracerebral hemorrhage in the right temporal lobe. Magnetic resonance imaging demonstrated further enlargement of the aneurysm. Emergency craniotomy found the lateral dural wall of the cavernous sinus was markedly expanded and torn by compression from the aneurysm. Rupture of the aneurysm into the intradural space through this dural defect was confirmed. The aneurysm was trapped after high-flow bypass, but the patient did not recover and died. Symptomatic enlarged intracavernous carotid artery aneurysm is potentially fatal and may indicate prompt surgical management.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracerebral Hemorrhage Caused by Ruptured Intracavernous Carotid Artery Aneurysm -Case Report-

Iwaisako

Toyota

Ishihara

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…Clinically, it is critical to discriminate between aneurysms proximal to the dural ring and aneurysms distal to the dural ring, because their locations determine surgical indications and the patient's prognosis 4,7,11,18) . If an unruptured proximal carotid aneurysm can be demonstrated with certainty to lie below the dural ring, the risk of subsequent SAH is extremely low, since the aneurysm is protected by the overlying anterior clinoid process and dural reflection 1,14) . Conventional angiography is considered to be the standard method for the evaluation of intracranial aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Distinction between Intradural and Extradural Aneurysms Involving the Paraclinoid Internal Carotid Artery with T2-Weighted Three-Dimensional Fast Spin-Echo Magnetic Resonance Imaging

Lee

Jung

Huh

et al. 2010

J Korean Neurosurg Soc

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Objective : The precise intra-vs. extradural localization of aneurysms involving the paraclinoid internal carotid artery is critical for the evaluation of patients being considered for aneurysm surgery. The purpose of this study was to investigate the clinical usefulness of T2-weighted threedimensional (3-D) fast spin-echo (FSE) magnetic resonance (MR) imaging in the evaluation of unruptured paraclinoid aneurysms. Methods : Twenty-eight patients with unruptured cerebral aneurysms in their paraclinoid regions were prospectively evaluated using a T2-weighted 3-D FSE MR imaging technique with oblique coronal sections. The MR images were assessed for the location of the cerebral aneurysm in relation to the dural ring and other surrounding anatomic compartments, and were also compared with the surgical or angiographic findings. Results : All 28 aneurysms were identified by T2-weighted 3D FSE MR imaging, which showed the precise anatomic relationships in regards to the subarachnoid space and the surrounding anatomic structures. Consequently, 13 aneurysms were determined to be intradural and the other 15 were deemed extradural as they were confined to the cavernous sinus. Of the 13 aneurysms with intradural locations, three superior hypophyseal artery aneurysms were found to be situated intradurally upon operation. Conclusion : High-resolution T2-weighted 3-D FSE MR imaging is capable of confirming whether a cerebral aneurysm at the paraclinoid region is intradural or extradural, because of the MR imaging's high spatial resolution. The images may help in identifying patients with intradural aneurysms who require treatment, and they also can provide valuable information in the treatment plan for paraclinoid aneurysms. KEY WORDS :Dural ring˙ Internal carotid artery˙ Magnetic resonance imaging˙ Paraclinoid aneurysms.

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The Pathology of Intracranial Arterial Aneurysms and Their Complications

Stehbens¹

1983

Intracranial Aneurysms

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Intracavernous Carotid Aneurysms: A Clinical-Pathological Report

Cited by 80 publications

References 0 publications

Intracerebral Hemorrhage Caused by Ruptured Intracavernous Carotid Artery Aneurysm -Case Report-

Intracerebral Hemorrhage Caused by Ruptured Intracavernous Carotid Artery Aneurysm -Case Report-

Distinction between Intradural and Extradural Aneurysms Involving the Paraclinoid Internal Carotid Artery with T2-Weighted Three-Dimensional Fast Spin-Echo Magnetic Resonance Imaging

The Pathology of Intracranial Arterial Aneurysms and Their Complications

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