[Direct surgical management of aneurysms in the cavernous sinus: a report of 5 cases].
Five patients with aneurysms in the cavernous sinus were treated by direct surgical approach. Two small aneurysms were located in the C3 segment, one small aneurysm was on the primitive trigeminal artery (PTA), and the last two aneurysms were giant ones. The three small aneurysms were discovered incidentally by angiography and the two giant aneurysms presented oculomotor palsy. After ordinary fronto-temporal craniotomy, the two C3 aneurysms were treated through an intradural approach, and the PTA aneurysm and the two giant aneurysms were treated through combined epi- and subdural approach. The three small aneurysms were clipped and the two giant aneurysms were trapped with the reconstruction of ICA by saphenous veins. In all cases the aneurysms were excluded postoperatively, but in one giant-aneurysm case (Case 5) the bypass was occluded postoperatively, but the patient had no permanent neurological deficit. The four patients developed third nerve palsy and one developed fourth nerve palsy which resolved within 3 to 6 months. In one C3-aneurysm case (case i) the patient had loss of vision due to much packing in the medial side of the ICA. All patients were discharged and returned to their usual life. Three cases (case 2, 4, 6) are presented here and the problems of direct surgical management of aneurysms in the cavernous sinus are discussed with the related literature.
Tokimura
H
H
Atsuchi Neurosurgical Hospital.
Atsuchi
M
M
Tokimura
Y
Y
Sato
E
E
Todoroki
K
K
Asakura
T
T
Fukushima
T
T
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery; D002343:Carotid Artery, Internal; D002426:Cavernous Sinus; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D013514:Surgical Procedures, Operative / Q000379:methods