Diagnosis and endoscopic endonasal management of nontraumatic pseudoaneurysms of the cranial base

Abstract

Symptomatic cranial base pseudoaneurysms should undergo treatment to obliterate the aneurysm and relieve the mass effect. First, formal angiography is necessary for accurate diagnosis and treatment planning. Next, endovascular occlusion is performed, with a preference for coiling or endoluminal reconstruction with a flow diverter. Last, endoscopic intervention follows in cases where: (1) decompression of vital structures is indicated; (2) diagnosis of the pseudoaneurysm cannot be definitively confirmed with angiography; or (3) the etiology of the confirmed pseudoaneurysm requires further investigation.

A “golden age” in skull base and rhinology research

“…This issue of the International Forum of Allergy & Rhinology ( IFAR ) represents a microcosm of the intellectual fecundity of the investigators who continue to improve techniques and outcomes in skull‐base surgery. Faden et al., from the Pittsburgh group, tackle the challenging topic of diagnosis and management of pseudoaneurysms of the petrous, cavernous, and clinoidal segments of the internal carotid artery through a retrospective analysis and literature review. Up to 20% of cases of arterial injury during endoscopic endonasal approaches may develop pseudoaneurysms .…”