Bilateral cavernous carotid aneurysms treated by two-stage extracranial-intracranial bypass followed by parent artery occlusion: case report and literature review.
Bilateral cavernous carotid aneurysms (CCAs) are often not amenable to neurosurgical clipping or endovascular coiling. Here, we report the case of a 50-year-old female who presented with a 1-year history of gradual severe headache. Preoperative angiograms revealed bilateral CCAs. Among these findings, the right giant CCA had been trapped after the external carotid artery-saphenous vein-middle cerebral artery (ECA-SV-MCA) bypass 8 years prior. Additionally, the left CCA was again trapped after the internal maxillary artery-radial artery-middle cerebral artery (IMA-RA-MCA) bypass, followed by parent artery occlusion (PAO), because of the enlargement of a 0.4-cm aneurysm to a 1.3-cm aneurysm during the 5th to 8th years following surgery. Postoperative radiologic findings proved that the aneurysms disappeared with good graft patency of the bilateral anastomoses and excellent filling of the bilateral MCA territories. This is the first case of bilateral CCAs treated with two stages of bilateral high-flow extracranial-intracranial (EC-IC) bypass, including an IMA-RA-MCA bypass.
Department of Neurosurgery, Affiliated Fuxing Hospital, Capital Medical University, Beijing, 100038, China.|Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China.
Yaoling
Y
Liu
Department of Neurosurgery, Affiliated Fuxing Hospital, Capital Medical University, Beijing, 100038, China. shixen@sina.com.|Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China. shixen@sina.com.
Xiang'en
X
Shi
Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China.
Fangjun
F
Liu
Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China.
Yuming
Y
Sun
Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China.
Hai
H
Qian
Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Rd, Haidian District, Beijing, 100093, China.
Ting
T
Lei
D002342:Carotid Artery, External / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002548:Cerebral Revascularization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery
Bilateral bypass; Cavernous carotid aneurysms; Enlargement; Extracranial–Intracranial bypass; Internal maxillary artery