Headache and cranial nerve dysfunction secondary to carotid artery aneurysm: two case reports and a literature review
DOI:
https://doi.org/10.48208/HeadacheMed.2022.35Keywords:
Aneurysm, Internal carotid artery, Cavernous sinus, Painful ophthalmoplegiaAbstract
The cavernous sinus is a venous plexus located at the base of the skull. Several pathologies, such as inflammatory, aneurysmal, or metastatic processes, can affect this plexus. Cavernous sinus syndrome occurs when the nerves are involved in this region (cranial nerves III, IV, VI, and divisions of V). These anatomical relationships explain that diplopia and pain are these patients' most common onset symptoms. Carotid cavernous aneurysms (CCAs) account for 2% to 9% of aneurysms. We report two patients who showed cavernous sinus syndrome resulting from carotid artery aneurysms. The recognition of the etiology of this distinguished clinical picture is vital to avoid complications and address the best approach for each patient.
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Barbosa AS, Lana MA. Síndrome do Seio Cavernoso: estudo de 70 casos. Arquivos Brasileiros de Oftalmologia 1998; 61(6)developing9. DOI:10.5935/0004-2749.19980005. DOI: https://doi.org/10.5935/0004-2749.19980005
Nair S, Nambiar R. Cavernous Sinus Syndrome. Proc (Bayl Univ Med Cent) 2017; 30(4):455-456, 2017. DOI:10.1080/08998280.2017.11930227. DOI: https://doi.org/10.1080/08998280.2017.11930227
Ambekar S, Madhugiri V, Sharma M, Cuellar H, Nanda A. Evolution of management strategies for cavernous carotid aneurysms: a review. World Neurosurg. 2014; 82:1077-1085. DOI:10.1016/j.wneu.2014.03.042.
Stiebel-Kalish H, Kalish Y, Bar-On RH, et al. Presentation, natural
history, and management of carotid cavernous aneurysms. Neurosurgery
;57(05):850–857.DOI: 10.1227/01.neu.0000179922.48165.42. DOI: https://doi.org/10.1227/01.NEU.0000179922.48165.42
Vasconcellos LP, Flores JAC, Veiga JCE, Conti MLM, Shiozawa P.
Presentation and treatment of carotid cavernous aneurysms. Arq
Neuropsiquiatr 2008;66(2A):189–193. DOI: 10.1590/s0004-282x2008000200009. DOI: https://doi.org/10.1590/S0004-282X2008000200009
Linskey ME, Sekhar LN, Horton JA, Hirsch WL Jr, Yonas H. Aneurysms of the intracavernous carotid artery: a multidisciplinary approach to treatment. J Neurosurg. 1991 Oct;75(4):525-34. DOI: 10.3171/jns.1991.75.4.0525. DOI: https://doi.org/10.3171/jns.1991.75.4.0525
Bouthillier A, van Loveren HR, Keller JT. Segments of the internal carotid artery: A new classification. Neurosurgery 1996; 38:425-33. DOI:10.1097/00006123-199603000-00001. DOI: https://doi.org/10.1227/00006123-199603000-00001
van Rooij WJ. Endovascular treatment of cavernous sinus aneurysms. Am J Neuroradiol 2012; 33: 323–326. DOI: 10.3174/ajnr.A2759. DOI: https://doi.org/10.3174/ajnr.A2759
Brown B and Hanel RA. Endovascular management of cavernous and paraclinoid aneurysms. Neurosurg Clin N Am 2014; 25: 415–424. DOI: 10.1016/j.nec.2014.04.017. DOI: https://doi.org/10.1016/j.nec.2014.04.017
Lam JJH, Shah MTBM, Chung SL, Ho CL. Persistent primitive trigeminal artery associated with a cavernous carotid aneurysm. Case report and literature review. J Radiol Case Rep. 2018 Nov;12(11):1-11. DOI: 10.3941/jrcr.v12i11.3500. DOI: https://doi.org/10.3941/jrcr.v12i11.3500
Neifert, S.N., Chapman, E.K., Martini, M.L. et al. Aneurysmal Subarachnoid Hemorrhage: the Last Decade. Transl. Stroke Res. 12, 428–446 (2021). DOI: 10.1007/s12975-020-00867-0. DOI: https://doi.org/10.1007/s12975-020-00867-0
Wiebers DO, Whisnant JP, Huston J 3rd, et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003; 362:103-110. DOI: 10.1016/s0140-6736(03)13860-3. DOI: https://doi.org/10.1016/S0140-6736(03)13860-3
Hodes JE, Fletcher WA, Goodman DF, Hoyt WF. Rupture of cavernous carotid artery aneurysm causing subdural hematoma and death. J Neurosurg. 1988; 69:617-619.5. DOI: 10.3171/jns.1988.69.4.0617. DOI: https://doi.org/10.3171/jns.1988.69.4.0617
Lee AG, Mawad ME, Baskin DS. Fatal subarachnoid hemorrhage from the rupture of a totally intracavernous carotid artery aneurysm: case report. Neurosurgery. 1996;38:596-598 [discussion:598-599]. DOI: 10.1097/00006123-199603000-00038. DOI: https://doi.org/10.1097/00006123-199603000-00038
Goldenberg-Cohen N, Curry C, Miller NR, et al. Long-term visual and neurological prognosis in patients with treated and untreated cavernous sinus aneurysms. J Neurosurg 2004;75:863-867. DOI: 10.1136/jnnp.2003.020917. DOI: https://doi.org/10.1136/jnnp.2003.020917
Ghorbani M, Hejazian SE, Dastmalchi A, Chavoshinejad M, Asaadi S. Orbital Compartment Syndrome Secondary to Direct Carotid Cavernous Fistula After Carotid Cavernous Aneurysm Rupture: Case Report and Review of Literature. World Neurosurg. 2020 Jan;133:409-412. DOI: 10.1016/j.wneu.2019.08.037. DOI: https://doi.org/10.1016/j.wneu.2019.08.037
Wanke I, Doerfler A, Stolke D, Forsting M. Carotid cavernous fistula due to a ruptured intracavernous aneurysm of the internal carotid artery: treatment with selective endovascular occlusion of the aneurysm. J Neurol Neurosurg Psychiatry. 2001 Dec;71(6):784-7. DOI: 10.1136/jnnp.71.6.784. DOI: https://doi.org/10.1136/jnnp.71.6.784
Arai N, Nakamura A, Tabuse M, Miyazaki H. Late-Onset Massive Epistaxis due to a Ruptured Traumatic Internal Carotid Artery Aneurysm: A Case Report. NMC Case Rep J. 2016 Nov 29;4(1):33-36. DOI: 10.2176/nmccrj.cr.2016-0139. DOI: https://doi.org/10.2176/nmccrj.cr.2016-0139
van der Schaaf EH, Buskens E, Rinkel GJ: Endovascular treatment of
aneurysms in the cavernous sinus: A systematic review on balloon occlusion
of the parent vessel and embolization with coils. Stroke 33:313–318, 2002.
DOI: 10.1161/hs0102.101479. DOI: https://doi.org/10.1161/hs0102.101479
Elhammady MS, Wolfe SQ, Farhat H, Ali Aziz-Sultan M, Heros RC. Carotid artery sacrifice for unclippable and uncoilable aneurysms: endovascular occlusion vs common carotid artery ligation. Neurosurgery. 2010 Nov;67(5):1431-6; discussion 1437. DOI: 10.1227/NEU.0b013e3181f076ac. DOI: https://doi.org/10.1227/NEU.0b013e3181f076ac
Ambekar S, Madhugiri V, Sharma M, Cuellar H, Nanda A. Evolution of management strategies for cavernous carotid aneurysms: a review. World Neurosurg. 2014 Dec;82(6):1077-85. DOI: 10.1016/j.wneu.2014.03.042. DOI: https://doi.org/10.1016/j.wneu.2014.03.042
Aguiar GB, Silva JM, Paiva AL, Jory M, Conti ML, Veiga JC. Endovascular treatment of carotid-cavernous vascular lesions. Rev Col Bras Cir. 2017 Jan-Feb;44(1):46-53. DOI: 10.1590/0100-69912017001007. DOI: https://doi.org/10.1590/0100-69912017001007
Lee H, Marotta TR, Spears J, Sarma D, Montanera W, Bharatha A. Endovascular treatment of cavernous carotid artery aneurysms: A 10-year, single-center experience. Neuroradiol J. 2021 Dec;34(6):568-574. DOI: 10.1177/19714009211013487. DOI: https://doi.org/10.1177/19714009211013487
Kaiser DPO, Cuberi A, Linn J, Gawlitza M. Flow diversion for compressive unruptured internal carotid artery aneurysms with neuro-ophthalmological symptoms: a systematic review and meta-analysis. J Neurointerv Surg. 2022 Aug 2:neurintsurg-2022-019249. DOI: 10.1136/jnis-2022-019249. DOI: https://doi.org/10.1136/jnis-2022-019249
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Copyright (c) 2022 Pedro Neves Fortunato, Danilo Takashi Yoshimatsu Ueno, Mariana Suemi Sukessada, Gabriel Santaterra Barros, João Fernando Cloclet Pio da Silva, Bruna Franchito Freire, Daniela Alves Gulhote, Ana Beatriz Barbosa Piffer, Hilton Mariano da Silva Junior
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