Symptomatic inferior cavernous sinus artery aneurysm associated with cerebral arteriovenous malformation.
A 50-year-old man presented with a symptomatic aneurysm arising from the right inferior cavernous sinus artery (ICSA) associated with a cerebral arteriovenous malformation (AVM) manifesting as a 3-month history of progressive right abducens nerve palsy. Cerebral angiography demonstrated a high-flow AVM and a saccular aneurysm arising from the right ICSA acting as a meningeal feeder. The symptom was thought to be attributable to aneurysmal mass effect rather than the AVM. The aneurysm was successfully treated with endovascular embolization and the symptom improved gradually. Hemodynamic stress in the ICSA may have resulted in the development of the aneurysm of the ICSA. Meningeal artery aneurysm presenting with cranial nerve palsy is extremely uncommon. The present case illustrates the need for detailed evaluation of the external carotid artery and internal carotid artery vasculature in patients with cerebral AVMs.
Department of Neurosurgery, Fnkuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
Masanori
M
Tsutsumi
Hiroshi
H
Aikawa
Tomonobu
T
Kodama
Minoru
M
Iko
Kouhei
K
Nii
Shuko
S
Matsubara
Housei
H
Etou
Kimiya
K
Sakamoto
Masanari
M
Onizuka
Kiyoshi
K
Kazekawa
D020434:Abducens Nerve Diseases / Q000209:etiology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002426:Cavernous Sinus / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged