title: Cavernous carotid artery aneurysms: epidemiology, natural history, diagnostic and treatment. An experience of a single institution.
abstract: BACKGROUND
  Cavernous carotid aneurysms (CCA) account for 2-9% of all intracranial aneurysms. They have been considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. These aneurysms are unique, their rupture can present in many different forms, they can suffer spontaneous thrombotic changes and the symptomatology related to the mass effect involves the neuro-ophthalmologic system. In this scenario the natural history and clinical presentation are largely different from other intracranial aneurysms. Some investigators advocate treatment of both symptomatic and asymptomatic CCAs, others recommend no treatment. The reason for this controversy relates to a lack of information on the long term natural history of these aneurysms, as well as on the long term results of treatment.
  
  
  METHODS
  In this article the authors discuss their single institution experience in diagnosis, natural history and management of 123 asymptomatic and oligosympotomatic aneurysms located in the cavernous portion of internal carotid artery.
  
  
  CONCLUSIONS
  According to our results asymptomatic or olygosymptomatic (pain) CCAs should be conservatively managed with serial images while the others presentations should be analyzed by a multidisciplinary team, involving the neuroendovascular and microsurgical services.
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: Jefferson
authors.initials: J
authors.lastname: Rosi Junior
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil. Electronic address: leonardowelling@yahoo.com.br.
authors.forename: Leonardo C
authors.initials: LC
authors.lastname: Welling
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: Lin Tchia
authors.initials: LT
authors.lastname: Yeng
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: José Guilherme
authors.initials: JG
authors.lastname: Caldas
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schafranski
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Hospital das Clínicas, da Faculdade de Medicina, Division of Neurological Surgery, School of Medicine, University of Sao Paulo, Rua Eneas C Aguiar, 255, Sao Paulo, SP, Brazil.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D018570:Risk Assessment; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult
keywords: Cerebral aneurysms; Historical cohort study; Treatment