Neonatal cavernous carotid artery aneurysm

Abstract: This chapter discusses issues surrounding the management of giant cavernous carotid artery aneurysms. These aneurysms most commonly present with symptoms of cranial neuropathy. They present a unique treatment challenge given their location and often large size. Endovascular flow diversion has emerged as the mainstay of treatment, although parent vessel sacrifice, high-flow bypass, and surgical trapping are important alternatives. Evaluation of the nature of collateral circulation and the tolerance of the intracranial circulation to carotid artery sacrifice should also be part of the work-up. The technical details of endovascular flow diversion strategy are described, as well as the management of known post-procedural complications.

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Subdural hemorrhage in the posterior fossa caused by a ruptured cavernous carotid artery aneurysm after a balloon occlusion test

Journal of Neurosurgery ◽

10.3171/jns.2006.105.2.315 ◽

2006 ◽

Vol 105 (2) ◽

pp. 315-319 ◽

Cited By ~ 6

Author(s):

Norberto Andaluz ◽

Thomas A. Tomsick ◽

Jeffrey T. Keller ◽

Mario Zuccarello

Keyword(s):

Carotid Artery ◽

English Literature ◽

Artery Aneurysm ◽

Balloon Occlusion ◽

Subdural Hemorrhage ◽

Occlusion Test ◽

Carotid Artery Aneurysm ◽

Balloon Occlusion Test ◽

History Of ◽

Cavernous Carotid Artery

✓Given the relatively benign natural history of cavernous carotid artery aneurysms and based on anecdotal reports in the literature of subarachnoid hemorrhage (SAH) or subdural hemorrhage (SDH) from these aneurysms, observation is warranted and typically recommended. In this case report, the authors describe a woman who harbored a partially thrombosed, giant cavernous aneurysm that ruptured after she underwent a balloon occlusion test (BOT) and predominately led to an SDH. The authors believe that this occurrence is the first such report in the English literature. They discuss possible mechanisms for this event and the literature related to SAH or SDH from cavernous aneurysms, including why cavernous aneurysms cause such hemorrhages. The authors also recommend that attention be paid to such lesions regarding the possibility of aneurysmal rupture following a BOT.

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Cavernous Carotid Artery Aneurysm Associated with Marfan's Syndrome: Treatment by Balloon Embolization Therapy

Neurosurgery ◽

10.1227/00006123-198802000-00003 ◽

1988 ◽

Vol 22 (2) ◽

pp. 297-300 ◽

Cited By ~ 23

Author(s):

Randall T. Higashida ◽

V. Van Halbach ◽

Grant B. Hieshima ◽

Leslie Cahan

Keyword(s):

Carotid Artery ◽

Intracranial Aneurysms ◽

Alternative Therapy ◽

Artery Aneurysm ◽

Marfan’S Syndrome ◽

Parent Vessel ◽

Marfan's Syndrome ◽

Carotid Artery Aneurysm ◽

Cavernous Carotid Artery ◽

Balloon Embolization

Abstract Intracranial aneurysms arising in the region of the cavernous carotid artery are difficult to manage surgically because of the surrounding cavernous sinus. With recent advances in microballoon technology and permanent solidification agents, it is now possible to treat certain intracranial aneurysms by detachable balloons and preserve the parent vessel. A patient with Marfan's syndrome presented with severe retroorbital pain, ophthalmoplegia, and headaches. Cerebral angiography demonstrated a large cavernous carotid artery aneurysm measuring 17 × 9 × 6 mm. This was successfully treated by placing three detachable balloons within the aneurysm and preserving the carotid artery via a transvascular approach. Intravascular detachable balloon embolization may offer a form of alternative therapy for the management of surgically difficult aneurysms. (Neurosurgery 22:297-300, 1988)

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