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Cavernous Internal Carotid Artery Aneurysm: Diplopia Due to a Large Cavernous Aneurysm Causing Oculomotor Nerve Palsy; Partial Coil Occlusion and p64 Flow Diverter Implantation; Resolution of the Cranial Nerve Palsy and Complete Clinical Recovery

  • Frances ColganEmail author
  • Marta Aguilar Pérez
  • Hansjörg Bäzner
  • Hans Henkes
Living reference work entry
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Abstract

A 48-year-old female patient presented with a sudden onset of diplopia. MRI/MRA and DSA demonstrated a large aneurysm of the cavernous segment of the right internal carotid artery (ICA). This aneurysm was treated with partial endovascular coil occlusion and implantation of three flow diverters, two p64, and one Pipeline Embolic Device (PED). The patient demonstrated hyper-response to dual antiplatelet therapy (aspirin and ticagrelor) which was managed by a monitored dosage reduction. The diplopia resolved 4 months after the endovascular treatment and DSA at 4 and 11 months and MRI/MRA at 5 months postprocedure confirmed the complete occlusion of the aneurysm with significant reduction in size. Extrasaccular flow diversion treatment for cavernous ICA aneurysms causing cranial neuropathy is the main topic of this chapter.

Keywords

Cavernous internal carotid artery Saccular aneurysm Diplopia Oculomotor nerve palsy Partial coil occlusion p64 flow diversion Dual anti-aggregation Hyper-response on platelet function inhibition medication 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Frances Colgan
    • 1
    Email author
  • Marta Aguilar Pérez
    • 2
  • Hansjörg Bäzner
    • 3
  • Hans Henkes
    • 2
  1. 1.Department of RadiologyUniversity of Otago, Christchurch HospitalChristchurchNew Zealand
  2. 2.Neuroradiologische KlinikNeurozentrum, Klinikum StuttgartStuttgartGermany
  3. 3.Neurologische KlinikNeurozentrum, Klinikum StuttgartStuttgartGermany

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