Document Detail

Intracavernous carotid artery aneurysms: the possible importance of angiographic dural waisting. A case report.
MedLine Citation:
PMID:  8956887     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cavernous carotid aneurysms are generally benign entities. Certain indications exist for their treatment, however, including transient ischemic events, subarachnoid hemorrhage or risk of subarachnoid hemorrhage, epistaxis or its risk, ophthalmoplegia, pain, and progressive visual loss. We feel certain angiographic features may indicate a greater likelihood that cavernous carotid aneurysms extend into the subarachnoid space, thus making their rupture a life-threatening event. METHODS: A case report of an intracavernous carotid aneurysm, which at surgery extended into the subarachnoid space, is described. RESULTS: In this particular case, deformation of the aneurysm (waisting) as seen at angiography was in retrospect an indication that the cavernous carotid aneurysm extended into the subarachnoid space, either through the dural ring or through the eroded dural roof of the cavernous sinus. This finding was verified at surgery when the lesion was explored and trapped. CONCLUSION: Angiographic waisting of a cavernous carotid aneurysm may indicate that the aneurysm extends into the subarachnoid space. Such extension means that rupture would be a life-threatening event. While deformation of the aneurysm may be secondary to compression against the optic nerve or anterior clinoid process with an intact layer of dura overlying the aneurysm, the neurosurgeon confronted with such findings should analyze such lesions carefully and consider surgical exploration.
M Horowitz; F Fichtel; D Samson; P Purdy
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  46     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-15     Completed Date:  1997-01-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  549-52     Citation Subset:  IM    
Department of Neurological Surgery, UT Southwestern Medical Center at Dallas, USA.
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MeSH Terms
Carotid Artery Diseases / pathology*,  radiography,  surgery
Cavernous Sinus / pathology*,  radiography,  surgery
Cerebral Angiography
Dura Mater / pathology*,  radiography,  surgery
Intracranial Aneurysm / pathology*,  radiography,  surgery
Magnetic Resonance Angiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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