Clinical and MRI long term evolution of intracavernous and carotid ophtalmic artery aneurysms, treated by common carotid ligation

In four large, 15-25 mm, internal carotid artery aneurysms (3 intracavernou s and 1 carotid ophtalmic), treatment by common carotid ligation was prefer red. Pre- and postoperative MRI were obtained, at a delay between 5 to 9 ye ars. Recovery of the ocular and visual symptomatology was a function of the role played by mechanical and/or ischaemic factors. No early or late conse quences, ascribable to the common carotid ligation, were observed. Aneurysm al thrombosis occurred in the first postoperative week, but retraction of t he thrombosed aneurysms was only obvious and maximal after several months. For this reason, rapid clinical recovery could be due, in the first instanc e, to the loss of aneurysmal pulsatility. Complete disappearance of the ane urysm was observed in two cases. In the other two, a small remnant of the i nitial lesion, without any unfavourable consequences, was revealed, respect ively 6 and 9 years after the intervention, by current, modern-days, MRA.