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Acta Neurochirurgica

, Volume 159, Issue 9, pp 1693–1698 | Cite as

Bilateral cavernous carotid aneurysms treated by two-stage extracranial-intracranial bypass followed by parent artery occlusion: case report and literature review

  • Yaoling Liu
  • Xiang’en ShiEmail author
  • Fangjun Liu
  • Yuming Sun
  • Hai Qian
  • Ting Lei
Case Report - Vascular

Abstract

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.

Keywords

Cavernous carotid aneurysms Extracranial–Intracranial bypass Internal maxillary artery Enlargement Bilateral bypass 

Notes

Acknowledgements

This work was supported by the grant: Beijing Municipal Natural Science Foundation (grant no. 7161005 to Xiang’en Shi) and the Science and Technology Commission Foundation of Beijing (grant no. Z161100000516019 to Xiang’en Shi)

Compliance with Ethical Standards

The patient/next of kin/guardian has consented to submission of this case report to the journal.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Yaoling Liu
    • 1
    • 2
  • Xiang’en Shi
    • 1
    • 2
    Email author
  • Fangjun Liu
    • 2
  • Yuming Sun
    • 2
  • Hai Qian
    • 2
  • Ting Lei
    • 2
  1. 1.Department of Neurosurgery, Affiliated Fuxing HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of Neurosurgery, Beijing Sanbo Brain HospitalCapital Medical UniversityBeijingChina

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