The benign course of cavernous carotid artery aneurysms

Mark J. Kupersmith Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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 M.D.
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Robert Hurst Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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Alejandro Berenstein Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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In Sup Choi Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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Jafar Jafar Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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Joseph Ransohoff Departments of Ophthalmology, Neurology, Neuroradiology, and Neurosurgery, New York University Medical Center, New York, New York

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Page Range:
690–693
Volume/Issue:
Volume 77: Issue 5
DOI link:
https://doi.org/10.3171/jns.1992.77.5.0690
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✓ Recently, the benign nature of aneurysms of the cavernous carotid artery has been questioned. In a review of cases evaluated from 1980 to 1990 with this developmental aneurysm, the authors found 70 patients with 79 cavernous carotid artery aneurysms. As expected, the great majority (59 patients) had ophthalmoplegia as the initial problem. Retro-orbital pain (three cases) and a carotid-cavernous fistula (five cases) were infrequently the sole manifestation. Mirror-image asymptomatic aneurysms were found in nine patients and asymptomatic cavernous aneurysms were found in three additional patients. Thirty-four patients not surgically treated were followed for a mean of 2.8 years, and 36 surgical patients were followed for a mean of 4.1 years prior to treatment. Of the 79 aneurysms, one (1.3%) ruptured into the subarachnoid space during this period. Other than optic neuropathy or cranial neuropathy, no patient had a permanent neurological deficit; the 12 asymptomatic aneurysms remained asymptomatic. It is concluded that an aneurysm of the cavernous carotid artery is rarely associated with life-threatening complications, and treatment should be considered principally for patients with intolerable pain or problems related to vision.

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Address reprint requests to: Mark J. Kupersmith, M.D., 530 First Avenue 3B, New York, New York 10016.
  • 1.

    Barr HWK, , Blackwood W, & Meadows SP: Intracavernous carotid aneurysms. A clinical-pathological report. Brain 94:607–622, 1971 Barr HWK, Blackwood W, Meadows SP: Intracavernous carotid aneurysms. A clinical-pathological report. Brain 94:607–622, 1971

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Cogan DG, & Mount HTJ: Intracranial aneurysms causing ophthalmoplegia. Arch Ophthalmol 70:757–771, 1963 Cogan DG, Mount HTJ: Intracranial aneurysms causing ophthalmoplegia. Arch Ophthalmol 70:757–771, 1963

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Ding MX: Traumatic aneurysm of the intracavernous part of the internal carotid artery presenting with epistaxis. Case report. Surg Neurol 30:65–67, 1988 Ding MX: Traumatic aneurysm of the intracavernous part of the internal carotid artery presenting with epistaxis. Case report. Surg Neurol 30:65–67, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Gauthier G, , Rohr J, & Wildi E, et al: L'hematome dissequant spontane de l'artere carotide interne: revue generale de 205 cas publies dont 10 personnels. Arch Suisse Neurol Psyehiatr 136:53–74, 1986 Gauthier G, Rohr J, Wildi E, et al: L'hematome dissequant spontane de l'artere carotide interne: revue generale de 205 cas publies dont 10 personnels. Arch Suisse Neurol Psyehiatr 136:53–74, 1986

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Hodes JE, , Fletcher WA, & Goodman DF, et al: Rupture of cavernous carotid artery aneurysm causing subdural hematoma and death. Case report. J Neurosurg 69:617–619, 1988 Hodes JE, Fletcher WA, Goodman DF, et al: Rupture of cavernous carotid artery aneurysm causing subdural hematoma and death. Case report. J Neurosurg 69:617–619, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Jefferson G: Concerning injuries, aneurysms and tumours involving the cavernous sinus. Trans Ophthalmol Soc UK 73:117–152, 1953 Jefferson G: Concerning injuries, aneurysms and tumours involving the cavernous sinus. Trans Ophthalmol Soc UK 73:117–152, 1953

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Kupersmith MJ, & Berenstein A: Neurovascular Neuro-ophthalmology. Heidelberg: Springer-Verlag (In press, 1992) Kupersmith MJ, Berenstein A: Neurovascular Neuro-ophthalmology. Heidelberg: Springer-Verlag (In press, 1992)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Kupersmith MJ, , Berenstein A, & Choi IS, et al: Management of nontraumatic vascular shunts involving the cavernous sinus. Ophthalmology 95:121–130, 1988 Kupersmith MJ, Berenstein A, Choi IS, et al: Management of nontraumatic vascular shunts involving the cavernous sinus. Ophthalmology 95:121–130, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Kupersmith MJ, , Berenstein A, & Choi IS, et al: Percutaneous transvascular treatment of giant carotid aneurysms: neuro-ophthalmologic findings. Neurology 34:328–335, 1984 Kupersmith MJ, Berenstein A, Choi IS, et al: Percutaneous transvascular treatment of giant carotid aneurysms: neuro-ophthalmologic findings. Neurology 34:328–335, 1984

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Lasjaunias P, & Berenstein A: Surgical Neuroangiography, I. Functional Anatomy of Craniofacial Arteries. Berlin: Springer-Verlag, 1987, pp 57–83 Lasjaunias P, Berenstein A: Surgical Neuroangiography, I. Functional Anatomy of Craniofacial Arteries. Berlin: Springer-Verlag, 1987, pp 57–83

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Linskey ME, , Sekhar LN, & Hirsch W Jr, et al: Aneurysms of the intracavernous carotid artery: clinical presentation, radiographic features, and pathogenesis. Neurosurgery 26:71–79, 1990 Linskey ME, Sekhar LN, Hirsch W Jr, et al: Aneurysms of the intracavernous carotid artery: clinical presentation, radiographic features, and pathogenesis. Neurosurgery 26: 71–79, 1990

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Markwalder TM, & Meienberg O: Acute painful cavernous sinus syndrome in unruptured intracavernous aneurysms of the internal carotid artery. Possible pathogenetic mechanisms. J Clin Neuro Ophthalmol 3:31–35, 1983 Markwalder TM, Meienberg O: Acute painful cavernous sinus syndrome in unruptured intracavernous aneurysms of the internal carotid artery. Possible pathogenetic mechanisms. J Clin Neuro Ophthalmol 3:31–35, 1983

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    McCormick WF, & Beals JD: Severe epistaxis caused by ruptured aneurysm of the internal carotid artery. J Neurosurg 21:678–686, 1964 McCormick WF, Beals JD: Severe epistaxis caused by ruptured aneurysm of the internal carotid artery. J Neurosurg 21:678–686, 1964

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Meadows SP: Intracavernous aneurysms of the internal carotid artery. Their clinical features and natural history. Arch Ophthalmol 62:566–574, 1959 Meadows SP: Intracavernous aneurysms of the internal carotid artery. Their clinical features and natural history. Arch Ophthalmol 62:566–574, 1959

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Morley TP, & Barr HWK: Giant intracranial aneurysms: diagnosis, course, and management. Clin Neurosurg 16:73–94, 1969 Morley TP, Barr HWK: Giant intracranial aneurysms: diagnosis, course, and management. Clin Neurosurg 16:73–94, 1969

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Mullan S: Carotid cavernous aneurysms and fistulae, in Dolenc VV (ed): The Cavernous Sinus. Wien: Springer-Verlag, 1987, pp 225–232 Mullan S: Carotid cavernous aneurysms and fistulae, in Dolenc VV (ed): The Cavernous Sinus. Wien: Springer-Verlag, 1987, pp 225–232

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Nishioka T, , Kondo A, & Aoyama I, et al: Subarachnoid hemorrhage possibly caused by a saccular carotid artery aneurysm within the cavernous sinus. Case report. J Neurosurg 73:301–304, 1990 Nishioka T, Kondo A, Aoyama I, et al: Subarachnoid hemorrhage possibly caused by a saccular carotid artery aneurysm within the cavernous sinus. Case report. J Neurosurg 73:301–304, 1990

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Nutik S: Carotid paraclinoid aneurysms with intradural origin and intracavernous location. J Neurosurg 48:526–533, 1978 Nutik S: Carotid paraclinoid aneurysms with intradural origin and intracavernous location. J Neurosurg 48: 526–533, 1978

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Pendl G, , Vorkapic P, & Richling B, et al: Strategies in intracavernous saccular aneurysms, in Dolenc VV (ed): The Cavernous Sinus. Wien: Springer-Verlag, 1987, pp 240–251 Pendl G, Vorkapic P, Richling B, et al: Strategies in intracavernous saccular aneurysms, in Dolenc VV (ed): The Cavernous Sinus. Wien: Springer-Verlag, 1987, pp 240–251

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Trobe JD, , Glaser JS, & Post JD: Meningiomas and aneurysms of the cavernous sinus. Neuro-ophthalmologic features. Arch Ophthalmol 96:457–467, 1978 Trobe JD, Glaser JS, Post JD: Meningiomas and aneurysms of the cavernous sinus. Neuro-ophthalmologic features. Arch Ophthalmol 96:457–467, 1978

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    van Beusekom GT, , Luyendijk W, & Huizing EH: Severe epistaxis caused by rupture of a non-traumatic infraclinoid aneurysm of the internal carotid artery. Acta Neurochir 15:269–284, 1966 van Beusekom GT, Luyendijk W, Huizing EH: Severe epistaxis caused by rupture of a non-traumatic infraclinoid aneurysm of the internal carotid artery. Acta Neurochir 15:269–284, 1966

    • PubMed
    • Search Google Scholar
    • Export Citation

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