Internal Carotid Artery Aneurysm Presenting Research Articles

Internal Carotid Artery Aneurysm Presenting as Lower Cranial Nerve Palsies

The signs of lower cranial nerve palsies are rare and are often caused by tumors. A 49-year-old woman was admitted to our hospital with progressive right-sided atrophy of the tongue, sternocleidomastoid and trapezius, dysarthria, and dysphagia for 3 years. Brain magnetic resonance imaging revealed a circular lesion adjacent to the lower cranial nerves. Cerebral angiography confirmed that the lesion was an unruptured aneurysm in the C1 segment of the right internal carotid artery. After endovascular treatment, the symptoms of this patient had partially improved.

Compressive Optic Neuropathy Caused by Internal Carotid Artery Aneurysm Presenting with Concurrent Neuromyelitis Optica

Purpose: To report a case of compressive optic neuropathy caused by an internal carotid artery aneurysm accompanied by concurrent neuromyelitis optica (NMO).Case summary: A 48-year-old female presented with sudden painless blurry vision in the inferior visual field of her right eye for 2 days. The corrected visual acuity was 0.7 in the right eye, and a relative afferent pupillary defect was observed. The visual field test demonstrated an inferior altitudinal defect in the right eye, while the color vision test was normal. However, after 5 days, she developed decreased color vision. Optic nerve enhancement in the right eye was observed on orbital magnetic resonance imaging, and anti-aquaporin-4 antibody was positive. She was diagnosed with NMO, and high-dose steroids were administered intravenously. In addition, brain magnetic resonance angiography showed a 5-mm aneurysm in the ophthalmic segment of the right internal carotid artery, which was compressing the optic nerve. Coil embolization of the aneurysm was performed. On the fourth day of steroid therapy and the first day after coiling, the corrected visual acuity in the right eye improved to 1.0. At 6-week follow-up, color vision and visual field defect also showed complete recovery.Conclusions: In this rare case of internal carotid artery aneurysm combined with NMO, early active treatment led to complete recovery of visual acuity and field defects.

Anesthesia in A Patient With an Internal Carotid Artery Aneurysm Presenting as Massive Recurrent Projectile Epistaxis: A Case Report

Severe projectile epistaxis due to non-traumatic internal carotid artery aneurysms is potentially life threatening but extremely rare, with hardly any report existing in the literature. We present the case of a 21-year old male with a history of recurrent torrential epistaxis associated with headache and dizziness. Catheter angiography revealed two aneurysmal dilatations at the cavernous and supraclinoid segments of the right internal carotid artery.

Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report

IntroductionDiplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process.Case ReportA 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology.DiscussionThe evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging.ConclusionSome causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm.

Endovascular treatment of a small ruptured non-traumatic internal carotid artery aneurysm presenting with repeated massive epistaxis

ObjectiveWe encountered a rare case of massive epistaxis resulting from a small ruptured non-traumatic cavernous internal carotid artery aneurysm associated a bony defect in the wall of the posterior lateral wall of the sphenoid sinus. We presented successful diagnosis and treatment with a balloon-assisted neck-plasty coil embolization. Case PresentationA 74-year-old Japanese man was admitted following recurrent massive epistaxis. There was no history of trauma, surgery, radiotherapy, infection, or tumor. Radiographic imaging demonstrated a bony defect in the wall of the posterior lateral wall of the sphenoid sinus that allowed the aneurysm to ruptured into the nasal cavity rather than intracranially. After rupture, the patient presented with epistaxis that resulted in systemic hypotension. This aneurysm can be managed rapidly using endovascular techniques of a balloon-assisted neck-plasty coil embolization. ConclusionThe present case report highlights the rarity of a small non-traumatic cavernous ICA aneurysm causing massive epistaxis. Clinicians should be aware of this possibility, as a high index of suspicion is required for proper diagnosis. Internal carotid angiography should be performed, particularly in patients with refractory epistaxis. Aneurysms in this location are usually amenable to endovascular treatment. Coil embolization using a microballoon-assisted neck-plasty technique can result in immediate hemostasis, parent artery preservation, and successful long-term aneurysm occlusion.

Letter to the Editor Regarding “Delayed Pipeline Embolization of a Ruptured True Internal Carotid Artery Aneurysm Presenting with Epistaxis—Case Report and Review of the Literature”

Letter to the Editor Regarding “Delayed Pipeline Embolization of a Ruptured True Internal Carotid Artery Aneurysm Presenting with Epistaxis—Case Report and Review of the Literature”

Endoscopic view of an internal carotid artery aneurysm presenting with hydrocephalus

Giant aneurysms (>25 mm) represent approximately 5–10% of all intracranial aneurysms. In this paper it’s reported a giant calcified aneurysm presenting with hydrocephalus. It’s highlighted the pre-operative images and intra-operative endoscopic findings.

Vocal Cord Paralysis as the First Sign of Spontaneous Carotid Dissection in a Patient With Extracranial Internal Carotid Artery Aneurysm

Spontaneous dissection of supra-aortic arteries is an exceptionally rare cause of vocal cord dysfunction. We are reporting a case of spontaneous carotid dissection and internal carotid artery aneurysm presenting as vocal cord paralysis. A 44-year-old female was admitted with hoarseness and swallowing disorders. Diagnostic imaging revealed dissection and obliteration of the right internal carotid artery (ICA) 23 mm from the carotid bifurcation. Electromyography revealed unilateral paralysis/paresis of the right vocal cord. Genetic analyses for thrombophilia, methylenetetrahydrofolate reductase, and plasminogen activator inhibitor 1 were found to be at high risk. The patient was discharged after 5 days without any neurological findings, and control angiography revealed complete restitution of the flow in the right ICA one month later. However, a fusiform aneurysm of the distal part of the extracranial right ICA was detected and excluded with endovascular procedure. Connective tissue systemic disorders and even mild trauma could initiate the dissection process of neck arteries. Precise diagnosis might be difficult even for an experienced neurologist, however, the final outcome is favorable.

Complete resolution of large intracranial aneurysm and cranial nerve deficits after endovascular treatment in an infant with tuberous sclerosis

Abstract Pediatric intracranial aneurysms are a rare entity, with an often reported prevalence ranging from 0.5% to 4.6%. Their etiology is poorly understood; however, their association with other congenital disorders, such as polycystic kidney disease and Marfan syndrome, has been widely documented in the pediatric neurosurgical literature. We present a case of a 9-month-old boy with tuberous sclerosis with a giant cavernous internal carotid artery aneurysm presenting with third nerve palsy.

An internal carotid artery aneurysm presenting with dysarthria

A 72-year-old woman presented to her general practitioner with a 4-week history of right neck swelling. Clinical examination elicited a pulsatile mass consistent with a carotid artery aneurysm. Five days later the patient noticed her tongue movements had become awkward with associated dysarthria. Computed tomography confirmed a 4cm internal carotid artery aneurysm arising just distally to the carotid bifurcation. She proceeded to transfemoral diagnostic carotid angiography. Balloon occlusion of the right internal carotid artery origin was performed for a ten-minute period without any neurological deficit. The decision was taken to proceed to surgical ligation of the origin of the internal carotid artery. Her symptoms of dysarthria have resolved.

Ruptured Internal Carotid Artery Aneurysm Presenting as a Sinonasal Organized Hematoma: Conventional Approach May Endanger Life

Sinonasal organized hematoma (SOH) is an uncommon benign entity with locally aggressive behavior. The conventional approach is complete resection. This approach, however, can cause massive hemorrhage and mortality in our patient due to a ruptured internal carotid artery (ICA) aneurysm hidden inside the SOH. To the best of our knowledge, this is the first case of a huge SOH with skull base invasion caused by a hidden ICA aneurysm, which usually would not be large enough to result in a sinonasal mass lesion. This case suggests that the possibility of an aneurysm should always be considered if a SOH is suspected, especially when it is huge and close to the ICA. Surgical resection may not be the first therapeutic choice unless the differential cause of a hidden aneurysm can be excluded.

Huge Internal Carotid Artery Aneurysm Presenting as Tonsillar Asymmetry

Aneurysms of the extracranial portion of the carotid artery are extremely rare. Internal carotid artery aneurysm is an uncommon cause of tonsillary asymmetry. Although internal carotid artery aneurysms usually remain asymptomatic, the clinical manifestation requires the tonsillar enlargement. Asymmetry as a sole determining factor for tonsillectomy may lead to unnecessary operations. We report a patient with a giant internal carotid artery aneurysm presenting as tonsillary asymmetry that might be mistaken for a tonsillar neoplasia. When faced with a tonsillar asymmetry, an otolaryngologist must keep aneurysms in mind.

Internal carotid artery aneurysm presenting as orofacial pain

We report a case of an internal carotid artery aneurysm presenting as orofacial pain. Case report and discussion. A 59-year-old patient presented with a four-year history of chronic oral pain accompanied by a right-sided occipital headache. No local organic pathology was detected, and a provisional diagnosis of persistent idiopathic facial pain was made. A neurosurgery referral was made to exclude neurovascular pathology, which resulted in the detection of an aneurysm originating from the right posterior communicating artery. This was successfully treated by coil embolisation, with subsequent resolution of symptoms. In this patient, an atypical history of pain with no other neurological signs or symptoms, other than accompanying occipital headache, led to the discovery of an intracranial aneurysm. This case highlights the need for appropriate referral and imaging in cases in which the clinical history and findings are not classical, and also emphasises the need for interdisciplinary management.

Spontaneous rupture of an intra-cavernous internal carotid artery aneurysm presenting with massive epistaxis

We report a rare case of epistaxis resulting from a ruptured internal carotid artery aneurysm, and present a successful treatment method. A 72-year-old woman was admitted following recurrent massive epistaxis. There was no history of trauma or surgery. Radiographic imaging demonstrated a large internal carotid artery aneurysm. An attempt was made to occlude the aneurysm with endovascular coils. Despite this, the patient went on to have further epistaxis. Endovascular ablation of the feeding internal carotid artery led to complete resolution. This case demonstrates that spontaneous epistaxis from intra-cavernous carotid artery aneurysms can be managed using endovascular techniques. To our knowledge, we report the first use of interventional radiological techniques to assess the collateral circulation to the brain and subsequently undertake endovascular ablation of the internal carotid artery.

Extracranial internal carotid artery aneurysm presenting with dysphagia and dysphonia

Extra cranial aneurysms of the internal carotid artery are extremely rare. We report a case of an extracranial internal carotid aneurysm in a 71 year old lady who presented with a right parapharyngeal mass with longstanding symptoms of dysphagia and dysphonia. The importance of MRI/CT to establish a radiological diagnosis before fine needle aspiration cytology or open biopsy of such masses is highlighted.

Enlargement of internal carotid artery aneurysm presenting with severe visual sequela: A case report and anatomy review

Background The majority of intracranial aneurysms arise from the internal carotid artery (ICA) circulation. The proximity of cranial nerves II to VI to the pathway of the internal carotid artery make them susceptible to damage from an ICA aneurysm, which may cause a variety of neurologic effects. Although vision loss is a relatively uncommon sequela of an ICA aneurysm, compression of the optic nerve by an aneurysm can cause visual field loss, decreased visual acuity, or both. Case Report An 85-year-old man with sudden-onset, painless, and profound monocular vision loss from compression of the optic nerve caused by an enlarged internal carotid artery aneurysm is described. Clinical presentation, detection, and treatment of an ICA aneurysm are discussed. conclusions An intracranial aneurysm or other compromise to the cerebral circulation should be ruled out in cases of vision loss that remain unexplained after a thorough ocular health evaluation, especially in patients with a history of cardiovascular disease or head injury.

Internal carotid artery aneurysm presenting as sinus pain

Sinusitis and its associated facial pain are frequently seen by ENT surgeons. However, it is important to have a high index of suspicion in cases with atypical symptoms, particularly those with unexplained, unilateral, severe facial pain, and to consider an internal carotid artery dissection. This important diagnosis accounts for almost 20 per cent of all strokes in the young, and anti-coagulation can help to prevent thrombosis and embolism. Two cases are presented for illustration.

Binge Eating Associated With Internal Carotid Artery Aneurysm

Back to table of contents Previous article Next article This article has been corrected | View Correction Letters to the EditorFull AccessBinge Eating Associated With Internal Carotid Artery AneurysmLINEN LIN M.D.SUSAN SHUR-FEN GAU M.D., Ph.D.MING-BEEN LEE M.D.,LINEN LIN M.D.Search for more papers by this authorSUSAN SHUR-FEN GAU M.D., Ph.D.Search for more papers by this authorMING-BEEN LEE M.D.Search for more papers by this author,Published Online:1 Aug 2006https://doi.org/10.1176/ajp.2006.163.8.1452AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Prevalence rates of DSM-IV binge eating disorder and intracranial aneurysm have been estimated at 1% (1) and 2%–5% (2) . To our knowledge, there has been no report of comorbidity of these two conditions. We describe a case of a patient with internal carotid artery aneurysm presenting with symptoms similar to binge eating disorder. “Mrs. A,” a 32-year-old married woman with two children, presented at a psychiatric clinic in Jan. 2003 with depressive symptoms and uncontrollable binge eating episodes that had been recurrent for 2 months. She became fixated with her body weight and waist circumference. Psychosexual stressors from her husband’s extramarital affairs were also identified. Neither compensatory behavior nor a history of anorexia was elicited.Despite alleviation of her depressed mood and preoccupation with body weight following treatment with paroxetine (30 mg/day) and weekly psychotherapy for 4 months, her binge eating episodes persisted. She was then lost to follow-up for several months. Subsequently, she relapsed and presented with the following at her visit in Jan. 2004: binge eating episodes, overconcern with waist circumference, depressed mood, decreased self-esteem, psychomotor agitation, episodic headaches, blurred visions, increased body weight (from 47 kg to 54 kg in 4 months), and increased severity of stress from marital conflict. There was no identified temporal relationship between her headaches and hyperphagia episodes. Similar to prior pharmacotherapy, fluoxetine doses (40 mg/day) were effective in reducing her symptoms of depression and body image distortion rather than controlling her binge eating impulse. Her physical examination revealed no negative findings except galactorrhea. Neither papilledema nor other focal neurological sign was identified at neurological examination. Her serum level of prolactin was within normal range (8.27 ng/ml). A magnetic resonance image of her pituitary disclosed an engorged vessel from the right internal carotid artery A1 segment compressed on the right optic chiasma and hypothalamus ( Figure 1 ). An angiography showed a wide-based aneurysm (maximum width: 5 mm; height: 4 mm) at the supraclinoid segment of the right internal carotid artery. Her blurred vision and headaches subsided after microsurgical decompression. She did not suffer from any binge eating episode or body image distortion during the postoperation follow-up for 20 months. Figure 1. Coronal View of T2-Weighted (TR: 400 msec, TE: 120 msec) Image of Brain MRI Revealing Engorged Vessel Rising From the Right Internal Carotid Artery A1 Segment With Compression on the Right Optic Chiasma and Hypothalamus An association between bulimia and central nervous system lesions and increased intracranial pressure has been reported previously (3) . To our knowledge, Mrs. A is the first reported case of internal carotid artery aneurysm presenting with a binge eating disorder. The disproportional treatment responses and evidence for focal neurological signs suggest the necessity for organic workup. It is advisable to perform detailed physical assessment, endocrinological evaluation, and possible neuroimaging studies in patients with binge eating disorder who have unexpected responses to traditional treatment strategies. Furthermore, our case report may provide additional evidence of a neurological basis of binge eating disorder. One limitation to this report is that it lacks analysis of the potential neural substrates for binge eating disorder. Taipei, Taiwan

Extracranial internal carotid artery aneurysm presenting as pharyngeal mass with dysphagia

Aneurysms of the extracranial portion of the internal carotid artery are rare. Generally, they occur just at the level of, or above, the bifurcation. Here we report a case of a left internal carotid artery aneurysm presenting as an oropharyngeal mass causing dysphagia.

Stent-graft treatment of extracranial internal carotid artery aneurysm

Extracranial internal carotid artery aneurysm is not a frequent finding. Although there are a number of methods used for the treatment of this kind of pathology, every approach should be tailored to the patient. The authors describe the case of a patient with a large extracranial internal carotid artery aneurysm presenting as a tumor of the parapharyngeal space, treated with a stent-graft. The patient remains asymptomatic at the 2-year follow-up. To our knowledge, this type of successful treatment of a carotid aneurysm has been reported only once so far.