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Cavernous Carotid Origin Aneurysm Rupture with Intracerebral Intraparenchymal Hemorrhage After Treatment of a Traumatic Barrow Type A Cavernous Carotid Artery Fistula

M. Horowitza, E. Levyb and E. Bonarotia

a Department of Neurosurgery and Radiology, University of Pittsburgh Medical Center
b Department of Neurosurgery, University of Buffalo SUNY


Figure 1
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  		Fig 1. Anteroposterior ICA arteriogram showing CCF with rapid venous drainage.


Figure 2
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  		Fig 2. Anteroposterior right common carotid artery arteriogram obtained after placement of 3 detachable silicon balloons (arrow) into the cavernous sinus. The direct CCF is absent.


Figure 3
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  		Fig 3. A, Axial T1-weighted MR image showing cavernous aneurysm with adjacent temporal lobe intraparenchymal hematoma (arrow).

B, Coronal T1-weighted MR image showing cavernous aneurysm (arrowhead) with adjacent intraparenchymal temporal lobe hematoma (arrow).


Figure 4
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  		Fig 4. Right lateral (A) and anteroposterior (B) ICA angiograms showing 19-mm cavernous origin aneurysm.


Figure 5
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  		Fig 5. Lateral (A) and anteroposterior (B) images showing coiled aneurysm and occluded right ICA.


Figure 6
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  		Fig 6. Postaneurysm/right ICA occlusion left ICA angiogram showing excellent cross-filling of the right cerebral anterior circulation and no retrograde aneurysm opacification.


Figure 7
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  		Fig 7. Xenon-CT CBF image, after right ICA sacrifice and aneurysm embolization, showing normal symmetric right and left hemispheric CBF.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X