[Interesting radiological and pathological findings of the internal carotid artery observed in a case of cavernous sinusitis (author's transl)].
A 47-year-old man was admitted to the neurosurgical department of Nagasaki University Hospital with complaints of high fever, deteriorated conciousness and nonpulsating exophthalmus on the left side. The first carotid angiography which had been done 2 days prior to admission, showed only an irregular narrowing in the cavernous portion of the left carotid artery. The right carotid angiogram did not show any recognizable abnormality. The second angiography which was performed 4 days after the admission, revealed an cylindrical aneurysmal opacification about 0.8 cm in diameter in the left intracavernous portion. The right angiography could not be done at that time. On the 47th hospital day, the third angiogram was performed. There noted again, the aneurysmal opacification in the left carotid artery and furthermore, the right carotid artery was occluded completely at its entrance into the cavernous sinus. On post-mortem examination, the cavernous sinus was filled with coagulated blood which drived from the ruptured left internal carotid artery. Microscopic examination revealed marked invasion of leucocytes to the wall of the internal carotid artery at the cavernous portion in both sides. These findings suggested that a mycotic aneurysm which resulted from the cavernous sinusitis ruptured into the left cavernous sinus and spelled blood compressed the opposite (right) carotid artery within the carvernous sinus which resulted in occlusion of the artery.
D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology; D002426:Cavernous Sinus / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000473:pathology; D012852:Sinusitis / Q000000981:diagnostic imaging* / Q000473:pathology