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Internal Carotid Artery Aneurysm

Aneurysm of Int Carotid Artery


Presentation

  • The present case indicates that an intrasellar ICA aneurysm can be misdiagnosed as a macroadenoma and even present through pituitary apoplexy.[ncbi.nlm.nih.gov]
  • We describe one such case in a patient with Noonan syndrome who presented with pulsatile neck mass. The diagnostic features and management of the aneurysm and a review of the literature are presented.[ncbi.nlm.nih.gov]
  • The clinical presentation may be an asymptomatic neck mass or there may be symptoms of upper aerodigestive tract compression.[ncbi.nlm.nih.gov]
  • The present case shows that thrombosed intracavernous ICA aneurysm may still carry the risk of rupture.[ncbi.nlm.nih.gov]
Hodgkin's Disease
  • Initially, it was thought to be a cerebral recurrence of the Non-Hodgkin's disease. Direct questioning revealed a long history of erectile dysfunction with loss of libido.[ndcn.ox.ac.uk]
Vascular Disease
  • Systemic examinations must be performed in patients with PSA in order to scrutinize associated anomalies or vascular disease.[ncbi.nlm.nih.gov]
  • Brill et al ( 4 ) hypothesized that childhood aneurysms can be linked to polycystic kidney disease, collagen vascular disease, subacute bacterial endocarditis, fibromuscular dysplasia, sclerosis, coarctation of the aorta, Marfan's syndrome, syphilis,[spandidos-publications.com]
  • diseases I73.0 Raynaud's syndrome Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.[icd10data.com]
Carotid Bruit
  • Examination may reveal neurological deficits, Horner's syndrome (half of cases), hemiparesis, carotid bruit.[patient.info]
Pulsatile Tinnitus
  • The symptoms associated with lateral extension of the petrous aneurysm into the tympanic cavity include dizziness, hearing loss, vertigo and pulsatile tinnitus ( 13 ).[spandidos-publications.com]
  • tinnitus or lower cranial nerve dysfunction due to dissection-related mass effect.[neuroangio.org]

Workup

  • When treating intrasellar masses with the slightest suspicion of a nonpituitary origin, further workup should be considered.[ncbi.nlm.nih.gov]
Hyperprolactinemia
  • Sellar and parasellar masses blocking inhibitory hypothalamic dopaminergic tonus can produce hyperprolactinemia.[ncbi.nlm.nih.gov]

Treatment

  • In the literature, factors linked to poorer outcome were age, vascular risk factors, initial ONP severity and delay before treatment; better recovery was associated with surgical treatment.[ncbi.nlm.nih.gov]
  • This further demonstrates the benefits of flow diversion for treatment of these aneurysms.[ncbi.nlm.nih.gov]
  • This case report describes a successful interdisciplinary approach for the treatment of a rare giant extracranial ICA aneurysm in a patient with Ehlers-Danlos syndrome. Treatment options for this type are few and carry high risks.[ncbi.nlm.nih.gov]
  • Mean intervals between the onset and treatment were significantly longer in microsurgical group (18.2 days) than in endovascular group (3.5 days).[ncbi.nlm.nih.gov]
  • Many treatments for posttraumatic, skull base aneurysms have been described.[ncbi.nlm.nih.gov]

Prognosis

  • Aneurysms at the posterior face of the internal carotid artery can lead to oculomotor nerve palsy (ONP) with an uncertain prognosis of recovery post-treatment.[ncbi.nlm.nih.gov]
  • Differential diagnosis of atypical vascular mass lesions should include neoplasm, because initial radical resection may be the key to achieve a better prognosis.[ncbi.nlm.nih.gov]
  • Clinical course and prognosis of temporal lobe epilepsy survey of 666 patients. Brain. 1971. 94: 173-90 4. Kuba R, Krupa P, Okacova L, Rektor I.[surgicalneurologyint.com]
  • Goldenberg-CohenN, CurryC, MillerNR, TamargoRJ, Murphy KPJ (2004) Long term visual and neurological prognosis in patients with treated and untreated cavernous sinus aneurysms.JNeurolNeurosurg Psychiatry 75:863-867 Higashida RT, Halbach VV, Dowd C, Barnwell[omicsonline.org]
  • Older patients and those with poorer Hunt and Hess grades on admission have a poor prognosis.[en.wikipedia.org]

Etiology

  • They also show that few phenotypes are specific for a genotypic disorder and highlight the importance of analysing different etiologies for aneurysm formation and anatomical disposition when taking treatment strategy decisions.[ncbi.nlm.nih.gov]
  • Parry-Romberg syndrome or progressive facial hemiatrophy is a rare clinical entity of an unknown etiology. We present the case of a 56-year-old woman with Parry-Romberg syndrome and a giant internal carotid artery aneurysm.[ncbi.nlm.nih.gov]
  • This is the first case that describes mutual contribution of cystic medial degeneration and ICA kinking in carotid aneurysm disease etiology successfully treated by aneurysm resection.[ncbi.nlm.nih.gov]
  • Conclusion: Epistaxis related to internal carotid artery aneurysm is quite rare but it is important to consider aneurysms in the etiology of epistaxis. Which may be fatal if the cause of nasal bleeding cannot be identified.[omicsonline.org]
  • Introduction Extracranial internal carotid artery aneurysms are rare, and according to their etiology they can be classified into atherosclerotic, dysplastic, inflammatory, infective or posttraumatic [ 1 ].[panafrican-med-journal.com]

Epidemiology

  • "Epidemiology and genetics of intracranial aneurysms". European Journal of Radiology . 82 (10): 1598–605. doi : 10.1016/j.ejrad.2012.12.026 . PMID 23399038 .[en.wikipedia.org]
  • Nordon IM, Hinchliffe RJ, Loftus IM, Thompson MM (2010) Pathophysiology and epidemiology of abdominal aortic aneurysms. Nat Rev Cardiol 8: 92–102. pmid:21079638 View Article PubMed/NCBI Google Scholar 17.[journals.plos.org]
  • Etiology and Epidemiology Most common etiological factor for AEICA is atherosclerosis with an incidence of 34 to 70% in different series.[ispub.com]
Sex distribution
Age distribution

Pathophysiology

  • In contrast, the pathophysiological mechanisms and natural course of ECAA are largely unknown. Understanding the pathophysiological background may add to prediction of risk for adverse outcome and need for surgical exclusion.[journals.plos.org]
  • We examined the pathophysiology underlying the development of olfactory hallucinations. We found craniotomy clipping and focal resection to be useful from the standpoint of seizure control.[surgicalneurologyint.com]
  • This is the pathophysiologic side of argument against a separate Lacerum segment. 3D-DSA of petrous segment aneurysm, confined below the PLL.[neuroangio.org]
  • These include 1p34-36, 2p14-15, 7q11, 11q25, and 19q13.1-13.3. [11] Pathophysiology [ edit ] Aneurysm means an outpouching of a blood vessel wall that is filled with blood. Aneurysms occur at a point of weakness in the vessel wall.[en.wikipedia.org]

Prevention

  • Coil embolization of the aneurysm and parent artery occlusion for the posttraumatic direct CCF was a good option to manage the abducens nerve palsy and to prevent postoperative hyperperfusion.[ncbi.nlm.nih.gov]
  • The surgical ICAA management is necessary to prevent severe complications. In cases of aneurysm extension to the skull base, double mandibular osteotomy is a safe technique that facilitates aneurysm exposure and control.[ncbi.nlm.nih.gov]
  • To prevent redilation, a tubular polyester external stent was fitted around the diseased segment.[ncbi.nlm.nih.gov]
  • This case of internal carotid artery aneurysm with a perforating artery arising from the aneurysm dome shows that sacrifice of the perforator may be necessary to prevent rebleeding.[ncbi.nlm.nih.gov]
  • Although stent-assisted coil embolization alone is an effective approach for treating BBAs, it is insufficient to prevent BBA regrowth. In contrast, stent-within-a-stent and covered stenting are effective at preventing rebleeding and BBA regrowth.[medsci.org]

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