Skip to main content Accessibility help
×
Home
Hostname: page-component-568f69f84b-h2zp4 Total loading time: 0.262 Render date: 2021-09-22T16:16:37.753Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Unusual Aneurysms of the Distal Internal Carotid Artery

Published online by Cambridge University Press:  18 September 2015

Gary J. Redekop*
Affiliation:
Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia.
Barrie Woodhurst
Affiliation:
Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia.
*Corresponding
323-C, 700 West Tenth Avenue, Vancouver, British Columbia, Canada V5Z 4E5
Rights & Permissions[Opens in a new window]

Abstract:

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Supraclinoid carotid aneurysms have traditionally been classified according to their relation to the major carotid branches, but considerable variation exists with respect to site of origin, projection, and relationship to the skull base. Distal internal carotid aneurysms with a superior or medial projection are uncommon vascular lesions, with an unusually high incidence of operative complications.

Methods:

Surgical experience with five patients suffering from subarachnoid hemorrhage due to ruptured aneurysms of the dorsomedial wall of the distal internal carotid artery is presented, with emphasis on their angiographic appearance, anatomical features, and operative management.

Results:

All five patients underwent surgical clipping. Intra-operative rupture occurred in two cases, with avulsion of the aneurysm from the internal carotid artery in both. A third patient experienced recurrent subarachnoid hemorrhage three days after uneventful surgery, due to the clip shearing off of the parent vessel.

Conclusions:

Distal internal carotid aneurysms do not conform to the usual principles of aneurysm formation and are unique in their dorsomedial location unrelated to an arterial bifurcation. Although their anatomy is straightforward and exposure is not restricted by bone or dural structures of the skull base, they possess extremely fragile necks which make surgical management particularly hazardous.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

1.Gibo, H, Lenkey, C, Rhoton, AL. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 1981; 55: 560574.CrossRefGoogle ScholarPubMed
2.Rhoton, AL. Anatomy of saccular aneurysms. Surg Neurol 1980; 14: 5966.Google ScholarPubMed
3.Batjer, HH, Kopitnik, TA, Giller, CA, Samson, DS. Surgery for paraclinoidal carotid artery aneurysms. J Neurosurg 1994; 80: 650658.CrossRefGoogle ScholarPubMed
4.Day, AL. Aneurysms of the ophthalmic segment: a clinical and anatomical analysis. J Neurosurg 1990; 72: 677691.CrossRefGoogle ScholarPubMed
5.Knosp, E, Müller, G, Perneczky, A. The paraclinoidal carotid artery: anatomical aspects of a microneurosurgical approach. Neurosurgery 1988; 22: 896901.CrossRefGoogle ScholarPubMed
6.Yasargil, MG. Microneurosurgery, Vol 2: Clinical Considerations, Surgery of the Intracranial Aneurysms and Results. New York: Georg Thieme Verlag, 1984; 33123.Google Scholar
7.Aldrich, F. Anterior (dorsal) paraclinoid aneurysm: case report. Surg Neurol 1991; 35: 374376.CrossRefGoogle ScholarPubMed
8.Ishikawa, T, Nakamura, N, Houkin, K, Nomura, M. Pathological consideration of a “blister-like” aneurysm of the superior wall of the carotid artery: case report. Neurosurgery 1997; 40: 403406.CrossRefGoogle ScholarPubMed
9.Nakagawa, F, Kobayashi, S, Takemae, T, Sugita, K. Aneurysm protruding from the dorsal wall of the internal carotid artery. J Neurosurg 1986; 65: 303308.CrossRefGoogle ScholarPubMed
10.Shigeta, H, Kyoshima, K, Nakagawa, F, Kobayashi, S. Dorsal internal carotid artery aneurysms with special reference to angiographic presentation and surgical management. Acta Neurochir (Wien) 1992; 119: 4248.CrossRefGoogle ScholarPubMed
11.Yoshimoto, Y, Ochiai, C, Nagai, M. Cerebral aneurysms unrelated to arterial bifurcations. Acta Neurochir (Wien) 1996; 138: 958964.CrossRefGoogle ScholarPubMed
12.Ferguson, GG. Physical factors in the initiation, growth, and rupture of human intracranial saccular aneurysms. J Neurosurg 1972; 37: 666677.CrossRefGoogle ScholarPubMed
13.Sekhar, LN, Heros, RC. Origin, growth, and rupture of saccular aneurysms: a review. Neurosurgery 1981; 8: 248260.CrossRefGoogle ScholarPubMed
14.Stehbens, WE. Etiology of intracranial berry aneurysms. J Neurosurg 1989; 70: 823831.CrossRefGoogle ScholarPubMed
15.Zubillaga, AF, Gugliemi, G, Viñuela, F, Duckwiler, GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of neck size with treatment results. Am J Neuroradiol 1994; 15: 815820.Google Scholar
16.Szikora, I, Guterman, LR, Wells, KM. Hopkins, LN. Combined use of stents and coils to treat experimental wide-necked carotid aneurysms: preliminary results. Am J Neuroradiol 1994; 15: 10911102.Google ScholarPubMed
17.Mericle, RA, Wakhloo, AK, Rodriguez, R, et al. Temporary balloon protection as an adjunct to endosaccular coiling of wide-necked cerebral aneurysms: technical note. Neurosurgery 1997; 41: 975978.CrossRefGoogle ScholarPubMed
You have Access
9
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Unusual Aneurysms of the Distal Internal Carotid Artery
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Unusual Aneurysms of the Distal Internal Carotid Artery
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Unusual Aneurysms of the Distal Internal Carotid Artery
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *