Abstract
A 64-year-old female was admitted to our hospital due to progressive visual deterioration on the right eye. Computed tomography (CT) scan showed a slightly high dense mass in the suprasellar region with a homogeneous enhancement. Angiography revealed a giant aneurysm (4.5 × 3.8 × 3.5 cm) in the C1 portion of the right internal carotid artery. The ligation of the right common carotid artery was performed and the postoperative course was uneventful.
About five years later, she was readmitted because of memory disturbance. CT scan showed a marked enlargement of the previously demonstrated giant aneurysm with the evidence of partial thrombosis. Right retrograde brachial angiograms confirmed a collateral circulation between vertebral artery and carotid artery, in which there was the flow from the muscular branches of vertebral artery to the right occipital artery and then to the external and internal carotid artery. She was discharged without operation because her family refused any further attempts at treatment.
This case suggested that the giant aneurysm may enlarge even after the ligation of common carotid artery. Therefore, follow-up study is necessary for a long term, and if the aneurysm failed to be thrombosed the ligation or trapping of the internal carotid artery should be considered.
