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Fig 1. A 48-year-old woman presenting in 1994 with visual field deficit from a right giant carotid ophthalmic aneurysm and acute left ophthalmoplegia from a left-sided carotid cavernous sinus aneurysm. A, Right ophthalmic aneurysm completely occluded with coils (see coil mesh in C and D). B, Left cavernous sinus aneurysm with intraluminal thrombus. Note additional small middle cerebral artery aneurysm. C, Angiogram 7 days after B shows enlargement of the aneurysm by resolution of intraluminal thrombus. D, Loose coil packing after embolization. Follow-up angiograms 6 to 72 months later showed progressive aneurysmal thrombosis with complete occlusion. E and F, MR imaging after 3 weeks (E) and 18 months (F). At 18 months, the aneurysm is almost completely obliterated. Visual field deficit remained unchanged, and ophthalmoplegia improved to isolated abducens palsy.
