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DOI: 10.1055/s-0038-1673119
Cavernous carotid artery aneurysms: epidemiology, natural history, diagnostic and treatment. An experience of a single institution
Publication History
Publication Date:
06 September 2018 (online)
Intoduction: Cavernous carotid aneurysms (CCA) account for 2–9% of all intracranial aneurysms and 15% of those originated in the internal carotid artery. They have been considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. These aneurysms are unique, their rupture can present in many different forms, they can suffer spontaneous thrombotic changes and the symptomatology related to the mass effect involves the neuro-ophthalmologic system.
Discution: In this scenario the natural history and clinical presentation are largely different from other intracranial aneurysms. Some investigators advocate treatment of both symptomatic and asymptomatic CCAs, others recommend no treatment. The reason for this controversy relates to a lack of information on the long term natural history of these aneurysms, as well as on the long term results of treatment. In this article the authors discuss their single institution experience in diagnosis, natural history and management of 123 asymptomatic and oligosympotomatic aneurysms located in the cavernous portion of internal carotid artery.
Conclusion: The authors concluded, divergent of the current literature, on the basis of their results that asymptomatic or olygosymptomatic CCAs should be conservatively managed with serial images while the others presentations should be analyzed, as other aneurysms, by a multidisciplinary team, involving the neurendovascular and microsurgical services.