Giant cavernous carotid aneurysm with spontaneous ipsilateral ICA occlusion: Report of 2 cases and review of literature
The second patient was a 55-year-old lady who presented with 2 episodes of generalized tonic clonic seizures 3 months prior to admission. She also developed visual deterioration in left eye, left ophthalmoparesis and left facial pain. Visual acuity in the left eye was perception of hand movements close to her face. She had paresis involving the left VI nerve, left relative afferent papillary defect and mild sensory loss in the left ophthalmic nerve distribution.\nMRI brain showed a 2.8 × 2.6 × 2.1 cm lesion in the cavernous sinus suggestive of giant ICA aneurysm [Figure and ]. DSA [Figure and ] revealed occlusion of the proximal ICA on the left side without any filling of the cavernous segment aneur ysm. On the right ICA injection, there was excellent cross flow across the anterior communicating artery, with a small aneurysm in the contralateral cavernous ICA.\nThis patient was also put on aspirin for stroke prevention. At 3-month follow-up, her visual acuity remained the same however, her ophthalmoparesis improved.