[Giant aneurysm of the internal carotid artery, stimulating parasellar tumor]

The authors report a case of a giant aneurysm of the internal carotid artery filling from the left internal carotid artery below the site of branching-off of the posterior communicating artery. The initial neurological, and ophthalmological signs and plain films of the skull suggested presence of an Erdheim's tumour. It is worth stressing that the onset of the clinical manifestations was at the age of 15 years, particularly in the form of progressing binasal hemianopsia with sparing of the lower temporal quadrant. The efficiency of the cerebral circulation was tested using Mathas' test, electroencephalography, ophthalmodynamometry and angiography. It was decided to ligate the left carotid artery although Mathas' test during angiography was not as positive. The boy tolerated the operation well. Ophthalmological examination demonstrated after 18 months normal visual fields and normal visual acuity. Further follow-up during 8 years demonstrated normal psychosomatic development of the boy.