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• Saleem Abdulrauf - Alchetron, The Free Social Encyclopedia
• Cerebral revascularization: extracranial-intracranial bypass.

Filed under Neurosurgery. Jonathon J. Lebovitz, Jorge L. Eller, Justin M. Longer follow-up is needed to evaluate the results and complications. Transitional internal carotid artery ICA aneurysms incorporate the cavernous, clinoidal, and supraclinoidal segments of the ICA as portions of the neck of the aneurysm. In this chapter we will review the natural history of giant internal carotid aneurysms, present our treatment results, and discuss surgical procedures and related technical aspects in the treatment of these aneurysms.

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Pure cavernous ICA aneurysms are a separate category of aneurysms that do not extend beyond the dural ring of the ICA. In the neurosurgical literature these aneurysms are considered benign, even when they are larger. T1 axial magnetic resonance image shows cavernous sinus aneurysm. B, Digital subtraction angiogram shows a giant cavernous internal carotid artery aneurysm does not extend into the supraclinoidal segment. Following balloon test occlusion, that night the patient had an acute headache, and pupils became fixed and dilated.

The patient subsequently died within 2 hours. C, Autopsy revealed rupture through the middle fossa dura into the temporal lobe. Unruptured giant intracranial aneurysms are being diagnosed more often as a result of the availability of better imaging techniques, and these lesions pose management problems for practitioners. The first series of giant aneurysms was presented in by Morley and Barr, who described giant aneurysms as greater than 25 mm.

Giant aneurysms have a female predominance with female:male ratios as high as in some series 4 and most commonly present in the middle decades of life. The natural history of giant aneurysms is one of a poor prognosis. Some have compared the fate of unruptured giant aneurysms to that of subarachnoid hemorrhage SAH. Giant aneurysms, not unlike other aneurysms, continue to enlarge over time.

Expansion is thought to be from growth of the lumen or thrombus formation within the sac. This progressive enlargement often causes symptoms of mass effect. Historically, it was thought that giant aneurysms were less prone to rupture; however, contemporary evidence suggests that this is inaccurate. Drake found that 62 of cases did rupture.

Rhoton AL. Dolenc VV. Springer; Anatomy and Surgery of the Cavernous Sinus.

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Verlag: G. Thieme; Color Atlas of Microneurosurgery: Intracranial Tumors. Day JD, Tschabitscher M. Churchill Livingstone; Microsurgical Dissection of the Cranial Base. Loftus CM.

Cranial Base Surgery. Thieme: Operative Neurosurgical Anatomy. Kobayashi S.

New York: Thieme; Neurosurgery of Complex Vascular Lesions and Tumors. Thieme Medical Publishers; Neurosurgical Operative Atlas: Neuro-Oncology. Advances and Technical Standards in Neurosurgery. Dolenc VV, Rogers L. Cavernous Sinus: Developments and Future Perspectives. Sindou M. Springer-Verlag; Photo Atlas of Skull Base Dissection. Abdulrauf SI. Elsevier Health Sciences; Progress in Clinical Neurosciences. Quinones-Hinojosa A. Elsevier - Health Sciences Division; Anatomical variations of the ten triangles around the cavernous sinus.

Clin Anat. Microsurgical anatomy of the cavernous sinus: measurements of the triangles in and around it. Skull Base. Umansky F. Vienna: Springer; Practical Handbook of Neurosurgery. Endoscopic endonasal transpterygoid approaches: anatomical landmarks for planning the surgical corridor.

Endoscopic endonasal approach to the middle cranial fossa through the cavernous sinus triangles: anatomical considerations. Neurol Med Chir. Endoscopic endonasal study of the cavernous sinus and quadrangular space: anatomic relationships. Head Neck. Anatomical study of the cavernous sinus emphasizing operative approaches. Turk Neurosurg. Expanded endonasal approach: vidian canal as a landmark to the petrous internal carotid artery.

J Neurosurg. Microsurgical anatomy of the cavernous sinus. Endoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus. Articles from Cureus are provided here courtesy of Cureus Inc. Clinical importance of morphology and nomenclature of distal attachment of temporalis tendon. Comparative analysis of surgical freedom and angle of attack of two minimal-access endoscopic transmaxillary approaches to the anterolateral skull base.

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