Cavernous Internal Carotid Artery Aneurysm: Visual Disturbance due to a Large Cavernous Aneurysm Presumably Causing Recurrent Retinal Ischemia; Coil Occlusion of the Aneurysm Together with the Parent Artery; Resolution of the Visual Disturbance and Clinical Recovery During Long-term Follow-up

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


A 44-year-old male patient presented with recurrent episodes of visual disturbance. CT, MRI/MRA, followed by DSA, demonstrated a large aneurysm of the cavernous segment of the left internal carotid artery (ICA). The left A1 segment was absent and a large caliber left posterior communicating artery (PcomA) with a patent P1 segment was present. The left anterior cerebral artery (ACA) was exclusively supplied by the right ICA via the anterior communicating artery (AcomA). A balloon test occlusion of the left ICA was tolerated without any neurological deficit. The aneurysm was treated endovascularly with coil occlusion of both the aneurysm and the parent artery (parent vessel occlusion, PVO). The episodes of visual disturbance did not recur and the PVO of the left ICA was tolerated without neurological deficit. During the following 6 years, the patient complained of dizziness, memory disturbance, and episodes of amnestic aphasia. Further examinations during this time failed to demonstrate any impairment of the cerebral perfusion. The treatment of large cavernous ICA aneurysms by PVO is the main topic of this chapter.


Cavernous internal carotid artery Saccular aneurysm Retinal ischemia Balloon test occlusion Parent vessel occlusion Collateral supply 


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© 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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