title: Treatment of a giant aneurysm of the cavernous internal carotid artery associated with a persistent primitive trigeminal artery: case report.
abstract: A case of an unruptured giant aneurysm of the cavernous portion of the left internal carotid artery associated with a persistent primitive trigeminal artery (PTA) is presented. The usual surgical approach to giant aneurysms at this site, including ligation of the ipsilateral internal carotid artery (ICA) and an extracranial-intracranial (EC-IC) bypass, was inadequate because of continued blood supply to the aneurysm via the PTA from the vertebrobasilar system. The patient was successfully treated with a combination of EC-IC bypass surgery, ICA ligation, and simultaneous intravascular balloon obliteration of the ICA just distal to the junction of the PTA and immediately proximal to the aneurysmal neck. Follow-up radiological investigations showed thrombosis of the aneurysm.
authors.affiliation: Department of Neurosurgery, Faculty of Medical Medicine, Kyoto University, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Miyatake
authors.forename: H
authors.initials: H
authors.lastname: Kikuchi
authors.forename: S
authors.initials: S
authors.lastname: Kondoh
authors.forename: T
authors.initials: T
authors.lastname: Higashi
authors.forename: S
authors.initials: S
authors.lastname: Yamagata
authors.forename: I
authors.initials: I
authors.lastname: Nagata
mesh_terms: D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002536:Cerebral Arteries / Q000002:abnormalities* / Q000473:pathology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014057:Tomography, X-Ray Computed