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Surgical management of giant intrapetrous internal carotid aneurysm presenting with coil exposure after endovascular treatment

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Abstract

Giant intrapetrous internal carotid aneurysms (petrous ICA aneurysm) are rare. A giant petrous ICA aneurysm presenting with otorrhagia and coil exposure to the external auditory meatus (EAM) after endovascular treatment has never been documented before. The authors report here a case of successful surgical trapping with bypass intervention of a giant petrous ICA aneurysm presenting with coil exposure after endovascular treatment. A 58-year-old man presented with persistent otorrhagia having been admitted to our hospital because of the recurrence of a giant petrous ICA aneurysm after repeated embolization treatments with coils. An electronic otoscope examination demonstrated that a piece of coil escaped into his right EAM. After multidisciplinary consultation, an extracranial-intracranial (EC-IC) bypass with ICA occlusion and coil removal with a closed EAM filling were performed in stages. The patient recovered quickly without any neurological deficits. A digital subtraction angiography confirmed the absence of the aneurysm and patency of the bypass graft.

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Acknowledgments

We thank Dr. Yin-Xia (Chief of the Otorhinolaryngology Department, Beijing Tiantan Hospital, Capital Medical University) for general support.

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China

    Le-Bao Yu, Dong Zhang & Ji-Zong Zhao

  2. China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, 100050, China

    Le-Bao Yu, Dong Zhang & Ji-Zong Zhao

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China

    Le-Bao Yu, Dong Zhang & Ji-Zong Zhao

  4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China

    Le-Bao Yu, Dong Zhang & Ji-Zong Zhao

  5. Center for Neuroscience Discovery, Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA

    Shao-Hua Yang

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  1. Le-Bao Yu
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  2. Dong Zhang
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Correspondence to Ji-Zong Zhao.

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The authors declare that they have no conflicts of interest.

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This report was approved by the patient and the institutional ethical review board of Beijing Tiantan Hospital.

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The patient approved the publication of this case presentation.

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Yu, LB., Zhang, D., Yang, SH. et al. Surgical management of giant intrapetrous internal carotid aneurysm presenting with coil exposure after endovascular treatment. Neurosurg Rev 41, 891–894 (2018). https://doi.org/10.1007/s10143-018-0964-y

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  • DOI: https://doi.org/10.1007/s10143-018-0964-y

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