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Surgery for carotid dural ring aneurysms.

Yasuhiko Kaku¹, Shin-ichi Yoshimura, Noboru Sakai

¹Department of Neurosurgery, Gifu University School of Medicine, Tsukasamachi, Gifu, Japan.

Surgical Neurology

|May 29, 2004

Summary

Paraclinoid carotid aneurysms can straddle the intra- and extradural space. Surgical clipping requires opening the distal dural ring for successful treatment of these complex carotid aneurysms.

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Area of Science:

Neurosurgery
Vascular Neurology
Cerebrovascular Anatomy

Background:

Paraclinoid segment carotid aneurysms are typically intradural.
Infrequently, these aneurysms can extend into the extradural space.

Observation:

Two cases of unruptured carotid dural ring aneurysms are presented.
Aneurysmal sacs straddled the distal dural ring, projecting superiorly from the internal carotid artery.
Angiography revealed flattened domes with central indentations, indicating circumscription by the distal dural ring.

Findings:

Successful obliteration of aneurysms was achieved through clip application.
Broad opening of the distal dural ring was necessary for adequate surgical control.

Implications:

Aneurysmal dome indentation on angiography is a key indicator of distal dural ring involvement.
Surgical management of aneurysms straddling intra- and extradural spaces necessitates careful dural ring opening for effective clipping.

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