1. Surgery for carotid dural ring aneurysms
- Author
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Noboru Sakai, Yasuhiko Kaku, and Shinichi Yoshimura
- Subjects
Carotid Artery Diseases ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Anterior surface ,Neurosurgical Procedures ,Aneurysm ,medicine.artery ,otorhinolaryngologic diseases ,medicine ,Humans ,cardiovascular diseases ,Aged ,medicine.diagnostic_test ,business.industry ,Intracranial Aneurysm ,Clipping (medicine) ,Anatomy ,Middle Aged ,Case description ,medicine.disease ,Cerebral Angiography ,nervous system diseases ,Surgery ,body regions ,medicine.anatomical_structure ,Angiography ,cardiovascular system ,Dura Mater ,Neurology (clinical) ,Extradural space ,Internal carotid artery ,business ,Artery - Abstract
BACKGROUND Carotid aneurysms of the paraclinoid segment are usually located in the intradural space, but can infrequently straddle the intra- and extradural space. CASE DESCRIPTION We present 2 cases of unruptured carotid dural ring aneurysms with an aneurysmal sac that straddled the distal dural ring. Each paraclinoid aneurysm projected superiorly from the anterior surface of the internal carotid artery with a relatively flattened dome and central indentation on angiography. The aneurysmal domes were circumscribed by the distal dural ring and straddled the intra- and extradural space. After broad opening of the distal dural ring, aneurysms were successfully obliterated by clip application in parallel with the internal carotid artery. CONCLUSION These cases underscore the significance of an aneurysmal dome indentation on angiographic images as a reflection of aneurysmal circumscription by the distal dural ring. Aneurysms that straddle the intra- and extradural space may require broad opening of the distal dural ring for adequate control and clipping.
- Published
- 2004
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