title: [The surgery of giant symptomatic cavernous sinus aneurysms].
abstract: OBJECTIVE
  To evaluate the management and outcomes in patients with giant symptomatic cavernous sinus aneurysms who underwent aneurysms trapping with bypass, proximal carotid occlusion and aneurysms trapping.
  
  
  METHODS
  Twenty-three patients with giant symptomatic cavernous sinus aneurysms underwent surgery between February 2007 and March 2013, 3 cases were male and 20 cases were female patients, the age of the patients ranged between 24 and 68 years, mean age was 54.7 years. The pre-operative digital subtraction angiography (DSA) and ballon occlusion test (BOT) were performed to confirm the diagnosis and identify hemodynamic reserve with carotid occlusion, and the aneurysms trapping with bypass, aneurysms trapping and proximal occlusion of the internal carotid artery were performed according to BOT results. During the surgery, the neurophysiological monitoring and the intraoperative CT perfusion were used. The follow-up by DSA or CT angiography were made.
  
  
  RESULTS
  Seventeen patients underwent aneurysms trapping with bypass, 1 underwent aneurysms trapping and 5 underwent proximal occlusion of the internal carotid artery. After surgery, symptom improved in 4 cases, did not change in 10 cases, and new neural function deficit developed in 9 cases. The follow-up period were 3 months to 75 months. Two patients were lost. The Glasgow Outcome Scale of last follow-up were 5 in 19 patients, 3 in 1 patient and 1 in 1 patient.
  
  
  CONCLUSIONS
  The aneurysms trapping with bypass and proximal occlusion of the internal carotid artery are effective and reliable procedure for treatment of giant symptomatic cavernous sinus aneurysms in selected patients after evaluation of the pre-operative BOT, intra-operative neurophysiological monitoring and the intraoperative CT perfusion.
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Fuyu
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China. Email: szh301@sina.com.
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Bainan
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Xue
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Dingwei
authors.initials: D
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D002426:Cavernous Sinus / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome