Rare and Symptomatic Cavernous Donut-Shaped Aneurysm Treated by Flow Diverter Deployment

Abstract

Background: We describe the case of a 62-year-old woman who was admitted to our center for acute diplopia secondary to a left III cranial nerve palsy, left eyelid swelling and ptosis, and mild ipsilateral retroorbital pain. No other motor or sensitive deficits were observed.

Case description: Computed tomography angiography and digital subtraction angiography were performed, showing a 25-mm left intracavernous aneurysm with a central intrasaccular thrombus, an intrasaccular "swirling" flow with a donut-shape appearance. A flow-diverter stent was deployed bridging the aneurysmal neck.

Conclusions: Twelve months after the procedure the aneurysm was completely occluded, and the patient had totally recovered the cavernous syndrome. A careful literature review has been performed, and the different endovascular approaches have been analyzed.

Keywords: Aneurysm; Cavernous; Central; Donut; Flow diverter; Thrombus.