Presentation
CONCLUSION: 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]
Entire Body System
- Asymptomatic
We present the case of a 29-year-old man who was referred for an asymptomatic pulsatile mass. Computed tomographic angiography identified a true aneurysm between the carotid bifurcation and the base of the skull. [ncbi.nlm.nih.gov]
- Swelling
He was transferred to our department and diagnosed as having left acute subdural hematoma and acute brain swelling. Emergent evacuation of hematoma and external decompression were performed. [ncbi.nlm.nih.gov]
These symptoms can vary, depending upon what is compressed, but may include facial swelling, hoarseness or difficulty swallowing. Rarely, carotid artery aneurysms can rupture, or burst, which is a life-threatening problem. [my.clevelandclinic.org]
Episodes of transient blindness, syncope, swelling neck and pulsating tinnitus may also occur. Examination may reveal neurological deficits, Horner's syndrome (half of cases), hemiparesis, carotid bruit. [patient.info]
- Surgical Procedure
We report the case of an ECAA surgically treated and we reviewed the different therapeutic experiences in the literature. KEY WORDS: Carotid artery injuries - Saccular aneurysm - Endovascular procedures - Operative surgical procedures [minervamedica.it]
There are few reports in the medical literature about the etiology of this disease, relating it to atherosclerosis, arteritis and alterations due to trauma or after a surgical procedure. The natural history of this disease has not been defined. [jvascbras.org]
Cases were excluded if fungal arterial aneurysm complicated the course of local surgical procedure. The case of our patient and 10 additional cases of fungal internal carotid aneurysms are presented. [academic.oup.com]
Discussion Extracranial carotid artery (ECA) aneurysms are rare, only 0.1% to 2% of all surgical procedures of the ECA were performed for ECA aneurysms [ 2, 3 ]. [panafrican-med-journal.com]
Initially, the patient and the patients family refused the suggestion of any surgical procedures, including coil embolization, due to the high risks of brain surgery. [spandidos-publications.com]
- Coronary Atherosclerosis
Restenosis rates between 24% and 38% have been reported in studies using Jomed coronary stent grafts in cases of coronary atherosclerosis, which is not different from the restenosis rates of regular bare stent placement. [ajnr.org]
Cardiovascular
- Thrombosis
[…] associated thrombosis of the parent vessel has been well reported. [2], [3], [4], [5], [6] Factors that precipitate thrombosis are related to the ratio of aneurysm volume to the orifice size, the age of the aneurysm, and the hemodynamics within the parent [ijri.org]
The postoperative angiogram showed patency in all but one case (one asymptomatic thrombosis). During follow-up (mean, 152 months), there was one unrelated death, one focal epileptic seizure, and one controlateral TIA. [ncbi.nlm.nih.gov]
- Hypertension
A 46-year-old male chronic smoker with chronic hypertension and hypercholesterolemia had a recurrent internal carotid artery aneurysm 1 year after embolization. [ncbi.nlm.nih.gov]
Associated clinical features may include pain, haematuria, refractory hypertension, thromboembolism, dissection and rupture. [ 7 ] Dissections A tear in the tunica intima results in blood splitting the tunica media. [patient.info]
Recurrent epistaxis other than cavernous carotid aneurysm may be due to congestive heart failure, diabetes mellitus, hypertension, and a history of anemia. [omicsonline.org]
Other risk factors that contributes to the formation of aneurysm are: cigarette smoking, hypertension, female gender, family history of cerebral aneurysm, infection, and trauma. [en.wikipedia.org]
She had no hypertension or diabetes. There was no past history of infection or trauma. Neurological examination was normal. [jnnp.bmj.com]
- Vascular Disease
Systemic examinations must be performed in patients with PSA in order to scrutinize associated anomalies or vascular disease. [ncbi.nlm.nih.gov]
The critical role of hemodynamics in the development of the cerebral vascular disease. A review. J Neurosurg. 2010;112:1240-53. [ Links ] 4. Aguiar PH, Isolan G, Tahara A. Carotid cave aneurysms. Neurosurg Q. 2008;18(4):239-45. [ Links ] 5. [scielo.org.mx]
[…] disorders with mcc 300 Peripheral vascular disorders with cc 301 Peripheral vascular disorders without cc/mcc Convert I72.0 to ICD-9-CM Code History 2016 (effective 10/1/2015) : New code (first year of non-draft ICD-10-CM) 2017 (effective 10/1/2016) [icd10data.com]
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]
- Carotid Bruit
Examination may reveal neurological deficits, Horner's syndrome (half of cases), hemiparesis, carotid bruit. [patient.info]
Eyes
- Diplopia
Ocular neuromyotonia refers to paroxysmal involuntary contraction of one or more ocular muscles resulting in paroxysmal diplopia and strabismus. [ncbi.nlm.nih.gov]
Diplopia is secondary due to the compression of cranial nerves by aneurysm [ 10 ]. [omicsonline.org]
A 50-year-old woman presented with sudden-onset severe headache and vomiting associated with dull aching pain in the right eye, followed by diplopia, drooping of the right eyelid, and numbness over the right half of the face. [ijri.org]
Ears
- 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]
Neurologic
- Paresis
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. [ncbi.nlm.nih.gov]
In conclusions, sympathetic nerve paresis of the pupil can occur after clipping of an IC-PC aneurysm associated with subarachnoid hemorrhage. [alliedacademies.org]
- Cranial Neuropathy
Extra cranial carotid artery aneurysms. Surgery 1983 ; 93 : 319 –23. ↵ Lane RJ, Weisman RA, Savino PJ, et al. Aneurysm of the internal carotid artery at the base of the skull: an unusual cause of cranial neuropathies. [jnnp.bmj.com]
Workup
When treating intrasellar masses with the slightest suspicion of a nonpituitary origin, further workup should be considered. [ncbi.nlm.nih.gov]
Treatment
RESULTS: 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]
Prognosis
BACKGROUND: 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]
Older patients and those with poorer Hunt and Hess grades on admission have a poor prognosis. [en.wikipedia.org]
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]
Etiology
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]
Etiology and Epidemiology Most common etiological factor for AEICA is atherosclerosis with an incidence of 34 to 70% in different series. [ispub.com]
Carotid free-floating thrombus (FFT) is a rare cause of ischemic stroke, usually detected during etiologic vascular studies. There is no consensus regarding the management of carotid free-floating thrombi in those patients. [revecuatneurol.com]
Epidemiology
"Epidemiology and genetics of intracranial aneurysms". European Journal of Radiology. 82 (10): 1598–605. doi : 10.1016/j.ejrad.2012.12.026. [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]
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]
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]