Congenital Middle Ear Aneurysm of Internal Carotid

Stallings, James O.; McCabe, Brian F.

doi:10.1001/archotol.1969.00770030041009

Cited by 43 publications

(13 citation statements)

References 4 publications

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“…58 In such cases, it has been postulated that aneurysms of the petrous ICA may arise directly from the main artery or from petrous ICA branches such as the caroticotympanic or vidian artery, the periosteal artery, and the persistent stapedial arteries. 60,61 These aneurysms are thought to form as a result of developmental defects in the muscular, middle layer of the vessel.…”

Section: Pathophysiologymentioning

confidence: 99%

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

Liu

Gottfried²,

Amini³

et al. 2004

FOC

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Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

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Section: Pathophysiologymentioning

confidence: 99%

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

Liu

Gottfried²,

Amini³

et al. 2004

FOC

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“…Intrakranielle Karotisaneurysmen liegen regelhaft in unmittelbarer Nachbarschaft des Sinus cavernosus, weil die Arterienwand an dieser Stelle zwischen Foramen lacerum und Dura mater kein Widerlager besitzt [13,17]. Im petrösen Anteil ist die A.carotis hingegen vollständig in einen stützenden Knochenkanal gebettet, der aneurysmatische Aussackungen verhindert.…”

Section: Diskussionunclassified

“…Prädilektionsstellen sind die Abgänge der Aa. pterygoidea et caroticotympanica, weil hier Lücken in der Elastica interna der Tunica media vorliegen [14,17].…”

Section: Diskussionunclassified

“…Die klinische Symptomatik leitet sich aus Kompressionseffekten ab und kann Hörstörungen, pulsatilen Tinnitus, Schwindel, Otalgien, aber auch Dysphagien und periphere Facialisparesen beinhalten [1,7,10,[16][17][18][19][20]. Spontanrupturen führen aufgrund der extraduralen Lokalisation der Gefäßmiß- Der Otoskopie kommt zweifelsohne eine Schlüsselfunktion für die rechtzeitige Erkennung der Gefäßmißbil-dung zu.…”

Section: Diskussionunclassified

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Die Aneurysmablutung als Komplikation der Paracentese

Delank

Stoll

Schuierer

et al. 1998

HNO

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Aneurysms of the temporal part of the carotid artery are unusually rare. The literature contains only a few previous reports dealing with hemorrhage from such malformations. In the present case massive bleeding occurred from a right-sided intrapetrous aneurym after myringotomy, which was performed as treatment for bilateral secretory otitis media. Due to the absence of any specific symptoms and the masking effect of middle ear glue preoperative identification of the aneurysm was not possible. Subsequent angiography showed the large fusiform extension of the intrapetrous aneurysm as well as multiple intracranial aneurysms. Leakage from the aneurism was closed definitively with muscle, fascia lata and a gelatin-resorcin-formalin-glue (Cardial). In order to apply the tissue patch the hypotympanic site of the aneurism was exposed using a posterior otosurgical approach. Due to extensive intracranial collateralization to the vertebral arteries bleeding persisted even after ligation of both carotid arteries. Temporary cardiac asystole was then induced to allow safe closure of the aneurysm. Following surgery the patient sustained loss of hearing in her ear and a partial peripheral facial palsy.

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“…Petrous ICA aneurysms include pseudo-aneurysms caused by surgical manipulation, radiation therapy, trauma, mycotic, as well as true aneurysms. 1,2,4,6,10,12) These aneurysms are usually asymptomatic, but may manifest as hemorrhage or mass effect on the adjacent structures, and can develop variety of clinical signs and symptoms, such as epistaxis, otorrhagia, cranial nerve deficit, vertigo, and dizziness, 9) whereas association with subarachnoid hemorrhage (SAH) has not been reported. Here, we report an extremely rare case of ruptured petrous ICA aneurysm presenting with simultaneous occurrence of SAH and massive epistaxis.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Occurrence of Subarachnoid Hemorrhage and Epistaxis Due to Ruptured Petrous Internal Carotid Artery Aneurysm: Association With Transsphenoidal Surgery and Radiation Therapy -Case Report-

Endo

Fujimura

Inoue

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 62-year-old woman presented with simultaneous subarachnoid hemorrhage (SAH) and massive epistaxis. The patient had been treated for pituitary prolactinoma by two transsphenoidal surgeries, gamma knife radiosurgery, and conventional radiation therapy since age 43 years. Cerebral angiography showed left petrous internal carotid artery (ICA) aneurysm with slight stenosis on the adjacent left petrous ICA. She underwent superficial temporal artery-middle cerebral artery (STA-MCA) double anastomosis with endovascular internal trapping without complication the day after onset. Postoperative course was uneventful; the patient did not develop symptomatic vasospasm, recurrent epistaxis, or cerebrospinal fluid rhinorrhea. Postoperative angiography demonstrated complete disappearance of the aneurysm with patent STA-MCA anastomosis. The patient was discharged 2 months after surgery without neurological deficit. The present case is extremely rare with simultaneous onset of SAH and epistaxis caused by ruptured petrous ICA aneurysm. The transsphenoidal surgeries and radiation therapies might have been critical in the formation of the petrous ICA aneurysm.

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Congenital Middle Ear Aneurysm of Internal Carotid

Cited by 43 publications

References 4 publications

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

Die Aneurysmablutung als Komplikation der Paracentese

Simultaneous Occurrence of Subarachnoid Hemorrhage and Epistaxis Due to Ruptured Petrous Internal Carotid Artery Aneurysm: Association With Transsphenoidal Surgery and Radiation Therapy -Case Report-

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