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Direct operation on intracavernous giant aneurysm

  • H. Sano
  • V. K. Jain
  • Y. Kato
  • M. Shoda
  • H. Tanji
  • K. Katada
  • T. Kanno

Abstract

Operation on an intracranial giant aneurysm is one of the most difficult types of surgery. On the other hand operation of the cavernous sinus poses a challenge to neurosurgeons. We had a case of bilateral intracavernous giant aneurysms clipped by direct surgery. This woman developed bilateral abducens palsy, CT showed round contrast enhanced masses situated in both cavernous sinuses. Angiography showed bilateral intracavernous giant aneurysms. The patient was followed up in the outpatient clinic. She started complaining of a headache 2 years afterward. Repeat angiography showed the aneurysm increasing in size. An operation was scheduled following a balloon Matas test monitored by EEG, SEP and clinical symptoms. Frontotemporal craniotomy was done by the usual method. The anterior clinoid process and sphenoid wing were drilled. The cavernous sinus was opened after temporary trapping of the internal carotid artery. The aneurysm was opened and cut to make a carotid artery by clipping. The embolus and air was flushed out before opening and temporary clips. Patient had developed ophthalmoplegia which was improving 3 months after the operation.

Keywords

Internal Carotid Artery Cavernous Sinus Aneurysm Wall Giant Aneurysm Direct Operation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Barr HWK, Blackwood W, Meadows SP (1971) Intravenous carotid aneurysms. A clinical pathological report. Brain 94: 607–622PubMedCrossRefGoogle Scholar
  2. 2.
    Dolenc VV (1983) Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 58: 824–831PubMedCrossRefGoogle Scholar
  3. 3.
    Gelber BR, Sundt TM Jr (1980) Treatment of intracavernous and giant carotid aneurysms by combined internal carotid ligation and extra-intracranial bypass. J Neurosurg 52: 1–10PubMedCrossRefGoogle Scholar
  4. 4.
    Harris FS, Rhoton AL Jr (1976) Anatomy of the cavernous sinus. A microsurgical study. J Neurosurg 45: 169–180PubMedCrossRefGoogle Scholar
  5. 5.
    Jefferson G (1938) On the saccular aneurysms of the internal carotid artery in the cavernous sinus. Br J Surg 26: 267–302CrossRefGoogle Scholar
  6. 6.
    Johnston I (1976) Direct surgical treatment of bilateral intracavernous internal carotid artery aneurysms. Case report. J Neurosurg 51: 98–102Google Scholar
  7. 7.
    Lombardi G, Passerini A, Migliavacca F (1963) Intracavernous aneurysms of the internal carotid artery. AJR 89: 361–371Google Scholar
  8. 8.
    Mason TH, Swain GM, Osheroff HR (1954) Bilateral carotid cavernous fistula. J Neurosurg 11: 323–326PubMedCrossRefGoogle Scholar
  9. 9.
    Matsuda M, Matsuda I, Hanada H et al (1979) Intracavernous giant aneurysm associated with Marfan’s syndrome. Surg Neurol 12: 119–121PubMedGoogle Scholar
  10. 10.
    Seltzer J, Hurteau EF (1957) Bilateral symmetrical aneurysms on internal carotid artery within the cavernous sinus. Case report. J Neurosurg 14: 448–451PubMedCrossRefGoogle Scholar
  11. 11.
    Wilson CB, Myers FK (1963) Bilateral saccular aneurysms of the internal carotid artery in the cavernous sinus. J Neurol Neurosurg Psychiatry 26: 174–177PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1987

Authors and Affiliations

  • H. Sano
    • 1
  • V. K. Jain
    • 1
  • Y. Kato
    • 1
  • M. Shoda
    • 1
  • H. Tanji
    • 1
  • K. Katada
    • 1
  • T. Kanno
    • 1
  1. 1.Department of NeurosurgeryFujita-Gakuen Health UniversityToyoake, AichiJapan

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