title: Treatment of Symptomatic Bilateral Cavernous Carotid Aneurysms: Long-term Results of 6 Cases.
abstract: BACKGROUND
  Bilateral cavernous carotid aneurysms (CCAs) are very rare. A treatment strategy for symptomatic bilateral CCAs has not been established because of their complex pathogenesis. Here we report our treatment strategy and long-term results for 6 cases of symptomatic bilateral CCAs.
  
  
  METHODS
  From January 2007 to December 2013, we treated 6 patients (2 men and 4 women; mean age at first treatment, 56.0 years) with symptomatic bilateral CCAs.
  
  
  RESULTS
  All patients began to experience unilateral symptoms. Five of the 6 underwent high-flow bypass (HFB) with parent artery occlusion (PAO), and 1 received PAO only. Mean follow-up period after the first treatment was 61.3 months. All symptoms improved after the treatment. Five contralateral CCAs became enlarged during the follow-up period. Of these, 4 became symptomatic. One patient received superficial temporal-middle cerebral artery bypass with PAO, 2 received HFB with PAO, and 1 refused treatment. Final modified Rankin Scale scores were 0 in 4 patients, 1 in 1 patient, and 2 in 1 patient. There was no mortality in this series.
  
  
  CONCLUSIONS
  HFB with PAO is feasible as the first treatment for symptomatic bilateral CCAs. This treatment strategy steadies and simplifies future treatment of contralateral CCAs should they become symptomatic.
authors: Department of Neurosurgery, Kami-iida dai-ichi General Hospital, Nagoya, Japan; Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Yoichi
authors: Y
authors: Uozumi
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan. Electronic address: soknouge@med.nagoya-u.ac.jp.
authors: Sho
authors: S
authors: Okamoto
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Yoshio
authors: Y
authors: Araki
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Takashi
authors: T
authors: Izumi
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Noriaki
authors: N
authors: Matsubara
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Kinya
authors: K
authors: Yokoyama
authors: Department of Neurosurgery, Kami-iida dai-ichi General Hospital, Nagoya, Japan; Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Masaki
authors: M
authors: Sumitomo
authors: Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan.
authors: Shigeru
authors: S
authors: Miyachi
authors: Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors: Toshihiko
authors: T
authors: Wakabayashi
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000150:complications* / Q000628:therapy*; D002426:Cavernous Sinus / Q000473:pathology*; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Bilateral cavernous carotid aneurysms; bypass surgery; parent artery occlusion; treatment