Cavernous Carotid Artery Giant Aneurysm: Case Report and Literature Review

Abstract

The giant aneurysm of the cavernous internal carotid artery is an uncommon event. In the case of giant aneurysmal formation, the patient presents with some signs or symptoms, reported or observed on physical examination, which reveal a possible mass effect with neurovascular compression of the aneurysm, or even a subarachnoid hemorrhage due to the rupture of the aneurysm. We report the case of a 69-year-old patient who was admitted to the emergency department, referred by the basic health unit (BHU) of her locality for neurosurgical evaluation after suffering a mild traumatic brain injury (TBI). The patient, who was asymptomatic, carried with her a tomographic computerized examination of the skull, performed one day after the incident, evidencing left nodular parasellar lesion involving the cavernous sinus, discovered at random. After more specific clinical, laboratory and imaging exams, she was diagnosed with a giant aneurysm of the cavernous segment of the left internal carotid artery (LICA) and was submitted to endovascular embolization for correction.

Resumo

O aneurisma gigante de artéria carótida interna cavernosa é um evento incomum. Em tratando-se de formação aneurismática gigante, frequentemente o paciente apresenta-se com algum sinal ou sintoma, relatado ou observado ao exame físico, que revela eventual efeito de massa com compressão neurovascular do aneurisma, ou até hemorragia subaracnóidea por ruptura do mesmo. Relata-se o caso de uma paciente de 69 anos, que deu entrada no serviço de emergência encaminhada pela Unidade Básica de Saúde (UBS) da sua localidade para avaliação neurocirúrgica após traumatismo cranioencefálico (TCE) leve. A paciente, que estava assintomática, trazia consigo um exame tomográfico computadorizado de crânio, realizado um dia após o incidente, evidenciando lesão de aspecto nodular paraselar esquerda, envolvendo o seio cavernoso, descoberta por acaso. Após realização de exames clínicos, laboratoriais e de imagem mais específicos, foi diagnosticada com aneurisma gigante do segmento cavernoso da artéria carótida interna esquerda e submetida à embolização endovascular para correção.

Keywords

aneurysm - intracranial aneurysm - therapeutic embolization

Palavras-Chave

Aneurisma - Aneurisma Intracraniano - Embolização Terapêutica

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