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Rare and Symptomatic Cavernous Donut-Shaped Aneurysm Treated by Flow Diverter Deployment
Alessandro Sgreccia1, Antonio Caragliano2, Giuseppina Sanfilippo3
1Department of Radiology, AOU Ospedali Riuniti, Ancona, Italy.
World Neurosurgery
|October 13, 2018
Summary
A flow-diverter stent successfully treated a large intracavernous aneurysm causing cranial nerve palsy. The patient fully recovered, demonstrating the efficacy of endovascular treatment for complex aneurysms.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Background:
- A 62-year-old woman presented with acute diplopia, ptosis, and retroorbital pain due to left oculomotor nerve (III cranial nerve) palsy.
- The palsy was attributed to a large left intracavernous aneurysm.
Observation:
- Diagnostic imaging revealed a 25-mm left intracavernous aneurysm with a central thrombus and characteristic "swirling" intrasaccular flow.
- The aneurysm presented a unique "donut-shape" appearance on angiography.
Findings:
- A flow-diverter stent was successfully deployed across the aneurysm's neck.
- Post-procedure imaging at 12 months confirmed complete aneurysm occlusion.
Implications:
- This case highlights the effectiveness of endovascular treatment using flow-diverter stents for complex intracavernous aneurysms.
- Complete resolution of the patient's cavernous syndrome and neurological deficits was achieved.
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