Abstract
Two cases with giant aneurysm of the cavernous carotid artery were directly operated upon.
Case 1: A 68-year-old female was admitted on Nov. 12, 1981, complaining of double vision on left lateral gaze. Neurological examination revealed left abducens palsy and hypesthesia on the left forehead. A CT scan revealed a parasellar mass lesion. Left carotid angiography demonstrated obstruction of the left internal carotid artery in the cavernous portion.
Case 2: A 56-year-old male was admitted complaining of headache, nausea, vomiting, left ptosis, and double vision. On neurological examination left total ophthalmoplegia and hyperesthesia on the left forehead and cheek were found. A CT scan revealed a parasellar mass lesion. Left carotid angiography showed complete obstruction of the left internal carotid artery in the cavernous portion.
IC trapping was carried out in both cases with concomitant incision of the lateral wall of the cavernous sinus and evacuation of the aneurysmal contents. In case 1, simultaneous EC-IC bypass operation was also performed. In both cases postoperative course was favorable without any complications or neurological disturbances.
The objectives of the surgical treatment of infracrinoid giant aneurysms are: (1) to eliminate mass effects and pressure on adjacent structures, (2) to prevent aneurysmal rupture, and (3) to maintain or enhance the circulation to the brain. Our operative technique is described with particular emphasis on its safety and effectiveness
