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Age: 65
Sex: Female
History: 65 year old female, otherwise healthy.
Followed for 5 years with progressively enlarging left cavernous carotid aneurysm. Initially presented with subtle diplopia on distance viewing. No obvious eye movement abnormalities on initial bedside examination. Progressive worsening of diplopia, particularly over past year, prompted ophthalmologic referral for consideration of surgical improvement of her left 6th nerve palsy . Follow-up CTA demonstrates dramatic increase in the size of the lesion (1.5 cm in 2004, 2.5 cm in 2007). She has just had ophthalmologic surgery which improved her diplopia considerably.
She has fairly good angiographic collaterals. (moderate left PCOM, ACOM, and a large right PCOM with present left P1 segment). Balloon test occlusion has not yet been performed.
In addition to ongoing conservative management, there are several endovascular options available for the management of this lesion.
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Medi-Fax Atlas Series
