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. 2011 Jul;21(3):225-7.
doi: 10.4103/0971-3026.85373.

Case report: Thrombosed giant cavernous carotid artery aneurysm secondary to cervical internal carotid artery dissection: An unusual entity

Sachin S Baldawa  1 , Hima Pendharkar, Girish R Menon, Suresh R Nair
Affiliations

Case report: Thrombosed giant cavernous carotid artery aneurysm secondary to cervical internal carotid artery dissection: An unusual entity

Sachin S Baldawa et al. Indian J Radiol Imaging. 2011 Jul.

Abstract

Spontaneous thrombosis of a giant intracranial aneurysm with parent artery occlusion is known. The exact mechanism is however unclear and various theories have been proposed. We present an unusual case of an angiographically documented cervical internal carotid artery (ICA) dissection, which led to total occlusion of the ICA distal to the dissected site, with acute cessation of forward blood flow. This resulted in acute upstream thrombosis of the giant cavernous carotid artery aneurysm and an acute cavernous sinus syndrome-like presentation.

Keywords: Cavernous carotid artery; dissection, giant aneurysm; internal carotid artery; thrombosis.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1 (A–D)
Figure 1 (A–D)
Axial plain (A) and contrast-enhanced (B) CT scans of the brain show an isodense-to-hyperdense lesion (arrow) in the right cavernous sinus region, with central filling (arrowhead in B) after intravenous contrast. Axial T1W (C) and T2W (D) MRI images of the brain show partial thrombosis (arrow) of the right giant cavernous carotid aneurysm
Figure 2 (A–C)
Figure 2 (A–C)
Axial time-of-flight (TOF) MRI image (A) shows absence of flow (arrow) in the right cavernous carotid artery. Note the normal flow in the left carotid artery (arrowhead). Axial susceptibility-weighted MRI image (B) shows susceptibility artifacts (arrow) in the right cavernous carotid aneurysm. Lateral view of a digital subtraction angiogram (C) demonstrates the ‘string sign’ (arrowhead) in the cervical ICA, with occlusion of the internal carotid artery 1.5 cm distal to its origin (arrow), and nonfilling of the aneurysm. The ipsilateral ophthalmic artery (long arrow) is filling through the middle meningeal artery (double arrow)
See this image and copyright information in PMC

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