Infectious aneurysms of the cavernous carotid artery

• Published in: Journal de radiologie Vol. 81; no. 8; pp. 891 - 898
• Main Authors: Marsot-Dupuch, K, Riachi, S, Berthet, K, Azizi, L
• Format: Journal Article
• Language: French
• Published: France 01.08.2000
• Subjects: Adult; Aged; Aneurysm, Infected - diagnostic imaging; Aneurysm, Infected - therapy; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - therapy; Carotid Artery, Internal - diagnostic imaging; Cavernous Sinus - diagnostic imaging; Cerebral Angiography; Embolization, Therapeutic; Female; Follow-Up Studies; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Male; Sinus Thrombosis, Intracranial - diagnostic imaging; Sinus Thrombosis, Intracranial - therapy; Time Factors; Tomography, X-Ray Computed
• ISSN: 0221-0363

We describe 3 patients who developed infectious aneurysms of the cavernous carotid artery. The aneurysms were due to sphenoidal sinusitis in two patients and due to endocarditis in one. The acute and septic onset of the cavernous sinus syndrome, suggested thrombophlebitis of the cavernous sinus in all 3 patients. The diagnosis was established by magnetic resonance imaging and magnetic resonance angiography. Therapeutic internal carotid artery occlusion was indicated for a fissuration of their aneurysm manifested (n=3) by an episode of epistaxis (n=2) and blood in sphenoid sinus (depicted by MRI) in one case. We discuss the pathophysiology and management of bacterial aneurysms of the cavernous carotid artery. Close clinical and imaging follow-up should be performed for patients under antibiotherapy. Selective angiography with therapeutic occlusion of the carotid artery is discussed in patients with persistence of symptoms or if clinical findings are suggestive of fissuration or if aneurysmal sac diameter increases on follow-up imaging studies.