A giant thrombosed aneurysm of the petrous carotid artery presenting with cavernous sinus syndrome: Case report

Aneurysms involving the petrous carotid artery are rare and a review of the literature demonstrates that the mode of clinical presentation depends on the direction of expansion of the aneurysmal sac. The eighth nerve is the m ost commonly affected, followed by the fifth nerve, sixth nerve and seventh nerve, respectively. There has not been reported to date a lesion presenti ng with cavernous sinus syndrome. We present the case of a 46-year-old woma n who complained of left facial pain and pan-ophthalmoplegia, and was shown to have a giant thrombosed aneurysm of the petrous carotid artery extendin g into the cavernous sinus. Because preoperative evaluation of the patient revealed good collateral flow, proximal balloon occlusion of the left inter nal carotid artery was performed. Neurological symptoms of the patient reso lved 2 months after surgery except for the size of the left pupil. We concl ude that an aneurysm of the petrous carotid artery should be included in th e differential diagnosis of cases presenting with a cavernous sinus syndrom e. Early diagnosis followed by definitive treatment is important for the al leviation of clinical symptoms associated with this lesion.