Mycotic Aneurysms in the intracavernous portion of the internal carotid artery
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Two cases of mycotic aneurysms in the intracavernous portion of the internal carotid artery were reported.<BR>Case 1 : A 48 years old woman was admitted to the hospital because of a severe headache and a spike fever of three days' duration. She had a clinical feature of bacterial meningitis and had been treated with antibiotics. Over the next six days she presented with diplopia and drooping of the left eyelid, followed by total ophthalmoplegia. Cerebral angiography performed two weeks after admission revealed a giant aneurysm in the left intracavernous portion of the internal carotid artery. Cerebral angiography repeated a month later showed a reduction in the size of the aneurysm with a slight improvement of ophthalmoplegia. Since follow-up angiography which was performed after an intreval of one year demonstrated a significant enlargement of the aneurysm, ligation of the internal carotid artery was carried out.<BR>Case 2 : A 33 years old man was admitted to a local hospital with a diagnosis of bacteremia. A month later he was referred to the hospital because of progressive deterioration of left ophthalmoplegia. Crebral angiography carried out on admission revealed a giant aneurysm in the left intracavernous portion of the internal carotid artery. Repeated angiography performed on the 15th day following admission showed a further enlargement of the aneurysm. Ligation of the internal carotid artery obviously improved ophthalmoplegia.<BR>To our knowledge 24 cases with mycotic aneurysms in the intracavernous portion have been previously reported in the literature. Frequently encountered causes were bacterial meningitis and cavernous sinus thrombophlebitis secondary to infection in the adjacent area. Rupture of an aneurysm occurred in only one case. it is suggested that patients with mycotic aneurysms in this portion had a relatively good prognosis and follow-up angiography was useful for the management of aneurysms.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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