title: A surgical case of paraclinoid carotid aneurysm associated with ipsilateral cervical internal carotid artery dissection.
abstract: This report presents a 60-year-old with a large paraclinoid carotid aneurysm associated with cervical interal carotid artery (ICA) dissection (CICAD). She had a fall while riding a bicycle and hit her head on the ground. Computed tomography scan done at another facility showed a round mass lesion near the sella. Her medical history revealed gradual decrease in left eye vision since two years. Left carotid artery digital subtraction angiography demonstrated a CICAD with an intimal flap and a large paraclinoid aneurysm (15.5 mm in size). She underwent a high-flow bypass with a so-called double-insurance bypass and proximal ligation of the cervical ICA and the postoperative course was uneventful. She was discharged without any new neurological deficits. We suggest that the possible nature of carotid artery dissection (CAD)-related hemodynamic changes should be taken into consideration in cases of intracranial aneurysm associated with CAD.
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Kojiro
authors.initials: K
authors.lastname: Wada
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Sakakibara
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
mesh_terms: D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D007839:Functional Laterality; D006322:Heart Aneurysm / Q000150:complications / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed