Cavernous carotid aneurysms: to treat or not to treat?
Most cavernous carotid aneurysms (CCAs) are considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. However, several conditions may exist in which treatment of these aneurysms should be considered. Several options are currently available regarding the management of CCAs with resultant good outcomes, namely expectant management, luminal preservation strategies with or without addressing the aneurysm directly, and Hunterian strategies with or without revascularization procedures. In this article, we discuss the sometimes difficult decision regarding whether to treat CCAs. We consider the natural history of several types of CCAs, the clinical presentation, the current modalities of CCA management and their outcomes to aid in the management of this heterogeneous group of cerebral aneurysms.
Eddleman
Christopher S
CS
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. Eddleman@md.northwestern.edu
Hurley
Michael C
MC
Bendok
Bernard R
BR
Batjer
H Hunt
HH
D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002985:Clinical Protocols / Q000592:standards; D003663:Decision Trees; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D011859:Radiography; D018570:Risk Assessment; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards*