Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 1
Cavernous Segment Aneurysms of the Internal Carotid Artery
1Sağlık Bilimleri Üniversitesi, Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, İstanbul, Türkiye Internal carotid artery (ICA) aneurysms account for 31.5% of aneurysms. Intracavernous ICA aneurysms account for 4-9% of intracranial aneurysms and 9-25% of giant aneurysms. The cavernous segment (CS) of ICA begins at foramen lacerum, where the artery enters the cavernous sinus and ends at the proximal dural ring level after forming the siphon. Direct surgical approach to lesions within the cavernous sinus have been accepted as risky interventions for many years due to the low success rate. Excessive bleeding, cranial nerve deficits, and risk of the ICA being potentially traumatized are among the primary reasons for avoiding this approach. Besides subarachnoid hemorrhage (SAH), ICA aneurysms may arise with a wide range of clinical findings such as vision loss, ophthalmoplegia, pituitary insufficiency, ischemic stroke, carotid-cavernous fistula, and epistaxis, depending on the location, orientation and size of aneurysm. Since CS aneurysms are extradural, the hemorrhage incidence is lower than with other aneurysms; however, these aneurysms can reach giant sizes and often present with cranial nerve deficits. Despite using various treatment modalities, interventional radiological methods seem to be the most appropriate treatment modality for CSA aneurysms. However, direct surgical intervention should be performed to eliminate the pressure effect in aneurysms causing a mass effect. In this review, general information and a clinical review of cavernous ICA aneurysms will be presented with the literature. Anahtar Kelimeler : Aneurysm, Cavernous segment, Internal carotid artery, Subarachnoid hemorrhage