Giant cavernous carotid aneurysms: clinical presentation in fifty-seven cases.
OBJECTIVE
To review the presenting symptoms and ophthalmic findings of 57 patients with cavernous carotid aneurysms of giant size (> or = 2.5-cm diameter).


METHODS
Hospital charts of 57 patients with giant cavernous carotid aneurysms who presented to University Hospital in London, Ontario, Canada between 1961 and 1993 were reviewed. All patients were proven by cerebral angiography to have unruptured giant cavernous carotid aneurysms.


RESULTS
Forty-six patients (81%) were women (mean age, 54 years). The most common presenting symptoms were diplopia (89%), retroorbital pain (61%), headache (19%), diminished or blurred vision (14%), and photophobia (4%). The most common clinical sign was partial or complete ophthalmoplegia (93%). Trigeminal nerve involvement was found in 37% of patients. Other clinical signs included ptosis, decreased visual acuity, proptosis, and visual field defects.


CONCLUSIONS
This study characterizes a large group of patients with giant cavernous carotid aneurysms seen over a 30-year period at a single institution. As in previous studies, diplopia and retroorbital pain were the most common symptoms. The high incidence of ophthalmoplegia observed in this study may be explained by a greater compressive and/or ischemic effect of giant aneurysms compared with their smaller counterparts.
Hahn
C D
CD
Division of Neurology, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
Nicolle
D A
DA
Lownie
S P
SP
Drake
C G
CG
D000293:Adolescent; D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis*; D002343:Carotid Artery, Internal / Q000473:pathology*; D002426:Cavernous Sinus / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis*; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis*