Symptomatic Bilateral Cavernous Carotid Artery Aneurysms Presenting as an Acute Painful Complete Ophthalmoplegia: A Case Report and a Review of the Literature

Akkari M, Saied Z, Zouari R, Jeridi C, Nabli F, Belal S, Ghorbel IB and Sassi SB

Department of Neurology, National Institute of Neurology Mongi-Ben Hamida, Tunisia

^*Correspondance to: Manel Akkari 

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Abstract:

Background: Cavernous Carotid Aneurysm (CCA) is a rare entity, but it is predominately found in the elderly. Clinical data regarding the diagnosis and the management of bilateral cavernous carotid aneurysms in old patients are scarce. The aim of our study is to present a case of acute painful ophthalmoplegia in an old patient due to cavernous carotid aneurysm with an extensive literature review.
Case Report: A 92-year-old female patient presented with a complete ptosis of the right eye. Neurological examination showed right severe ptosis associated with complete ophthalmoplegia. Brain MRI revealed large bilateral CCAs causing compression of cranial nerves III, IV and VI in the right cavernous sinus. Medical treatment consisting of gabapentin and antalgic therapies had been initiated. At the three-month follow-up, the patient was clinically stable.
Conclusion: This case illustrates a rare presentation of CCA manifested by complete ophthalmoplegia in a very old female patient. This diagnosis should be considered as a possible etiology of cavernous sinus syndrome.

Keywords:

Bilateral cavernous carotid aneurysms; Cavernous sinus syndrome; Painful ophthalmoplegia; Management strategies

Cite the Article:

Akkari M, Saied Z, Zouari R, Jeridi C, Nabli F, Belal S, et al. Symptomatic Bilateral Cavernous Carotid Artery Aneurysms Presenting as an Acute Painful Complete Ophthalmoplegia: A Case Report and a Review of the Literature. World J Surg Surgical Res. 2023; 6: 1454..