Cavernous Sinus Syndrome Secondary to Internal Carotid Aneurysm

Abstract

The goal of this work is to share a rare case of cavernous sinus syndrome diagnosed in our department and to highlight the challenges in managing this condition in our department.Observation: It was a 48-year-old known hypertensive patient who presented with a sudden decrease in visual acuity associated with a drooping of the right upper eyelid over the past month. The ophthalmological examination revealed a visual acuity limited to 1/10th, severe ptosis, complete ophthalmoplegia, decreased corneal sensitivity, areflexic mydriasis, and papillary edema in the right eye. The left eye showed no particularity. Angio-MRI revealed a partially thrombosed aneurysm of the right internal carotid artery, causing compression of the vascular and neural elements due to mass effect. The patient treatment required a transfer to the Neurosurgery Department.Discussion: Internal carotid artery aneurysm is a rare cause of cavernous sinus syndrome. The diagnosis is primarily clinical, and neuroimaging confirms the origin of the condition. Endovascular treatment has revolutionized management, which depends on the size, location, and integrity of the aneurysm. Conclusion:The cavernous sinus syndrome is a diagnostic and therapeutic emergency. Its management is delicate and relies on embolization. The prognostic of this condition remains reserved in our countries, even with the advent of new revolutionary techniques.