History of left cavernous sinus aneurysm. The examination demonstrates expansion of the left cavernous sinus. In comparison with a prior brain MRI, it remains stable. The cerebral and cerebellar hemispheres are normal in attenuation and morphology. There is no intracranial hemorrhage, edema, midline shift or abnormal extra-axial fluid collection. The ventricles are normal in volume and symmetric.Visualized paranasal sinuses mastoid air cells are normally pneumatized. The bony density of the calvarium and skull base is radiographically normal.CTA shows a gigantic aneurysm in the anterior aspect of the left internal carotid artery, which is mostly within the cavernous sinus with little expansion into the supraclinoid segment. It measures 14.4 x 19.2 mm on the sagittal view and 19.9 x 12.0 mm on the coronal view. In addition, little ectasia of the right internal carotid artery is noted. The right internal carotid, vertebral, basilar and their intracranial major branches are patent with no evidence of aneurysm or significant stenosis.
Grossly stable left cavernous sinus fusiform aneurysm as detailed above. 