Intoduction: Cavernous carotid aneurysms (CCA) account for 2–9% of all intracranial aneurysms
and 15% of those originated in the internal carotid artery. They have been considered
benign lesions, most often asymptomatic, and to have a natural history with a low
risk of life-threatening complications. These aneurysms are unique, their rupture
can present in many different forms, they can suffer spontaneous thrombotic changes
and the symptomatology related to the mass effect involves the neuro-ophthalmologic
system.
Discution: In this scenario the natural history and clinical presentation are largely different
from other intracranial aneurysms. Some investigators advocate treatment of both symptomatic
and asymptomatic CCAs, others recommend no treatment. The reason for this controversy
relates to a lack of information on the long term natural history of these aneurysms,
as well as on the long term results of treatment. In this article the authors discuss
their single institution experience in diagnosis, natural history and management of
123 asymptomatic and oligosympotomatic aneurysms located in the cavernous portion
of internal carotid artery.
Conclusion: The authors concluded, divergent of the current literature, on the basis of their
results that asymptomatic or olygosymptomatic CCAs should be conservatively managed
with serial images while the others presentations should be analyzed, as other aneurysms,
by a multidisciplinary team, involving the neurendovascular and microsurgical services.
