Restricted accessResearch articleFirst published online 2010-12
Pseudoaneurysm Formation following Intrasphenoid Rupture of an Idiopathic Intracavernous Carotid Artery Aneurysm: Coil Migration and Early Recurrence after Endovascular Treatment
Intrasphenoid rupture of a non-traumatic aneurysm of the cavernous carotid artery is rare. We describe a patient in whom this condition manifested with epistaxis and led to the formation of a pseudoaneurysm occupying the right sphenoid sinus. The lesion recurred after repeated attempts at conservative endovascular therapy. Eventually the patient was treated with endovascular occlusion of the right internal carotid artery. Our report emphasizes the relapsing behaviour of a non-traumatic aneurysm of the cavernous portion of the internal carotid artery ruptured into the sphenoid sinus.
EddlemanCSHurleyMCBendokBR. Cavernous carotid aneurysms: To treat or not to treat?Neurosurg Focus. 2009; 26: E4.
2.
LinskeyMESekharLNHirschWJr. Aneurysms of the intracavernous carotid artery: Clinical presentation, radiographic features, and pathogenesis. Neurosurgery. 1990; 26: 71–79.
3.
van der SchaafICBrilstraEHBuskensE. Endovascular treatment of aneurysms in the cavernous sinus. A systematic review on balloon occlusion of the parent vessel and embolization with coils. Stroke. 2002; 33: 313–318.
4.
CohenJEGomoriJMSegalR. Result of endovascular treatment of traumatic intracranial aneurysms. Neurosurgery. 2008; 63: 476–486.
5.
LehmannPSaliouGPageC. Epistaxis revealing the rupture of a carotid aneurysm of the cavernous sinus extending into the sphenoid: Treatment using an uncovered stent and coils. Review of the literature. Eur Arch Otorhinolaryngol. 2009; 266: 767–772.
6.
LempertTEHalbachVVHigashidaRT. Endovascular treatment of pseudoaneurysms with electrolytically detachable coil. Am J Neuroradiol. 1998; 19: 907–911.
7.
LeeDHHurSHChoiSJ. A recurred carotid siphon pseudoaneurysm after detachable coil embolization: Successful endovascular management with detachable balloons. Interv Neuroradiol. 2008; 8: 61–65.
SluzewskiMvan RooijWJ. Early rebleeding after coiling of ruptured cerebral aneurysms: Incidence, morbidity, and risk factors. Am J Neuroradiol. 2005; 26: 1739–1743.
10.
StruffertTBuhkJHBuchfelderM. Coil migration after endovascular coil occlusion of internal carotid artery pseudoaneurysms within the sphenoid sinus. Minim Invas Neurosurg. 2009; 52: 89–92.
11.
LylykPFerrarioAPasbonB. Buenos Aires experience with the Neuroform self-expanding stent for the treatment of intracranial aneurysms. J Neurosurg. 2005; 102: 235–241.
12.
FluriFEngelterSLyrerP. Extracranial-intracranial bypass surgery for occlusive carotid artery disease. Cochrane Database Syst Rev.2010; 17; 2: CD005953.
