MRI findings of carotid cavernous aneurysms treated by IC ligation and bypass surgery

Postoperative outcomes and MRI findings after extracranial-intracranial (EC-IC) bypass and IC ligation were examined of 6 patients with symptomatic carotid cavernous aneurysms at our hospital from 2001 to 2004. All the patients were women, and their mean age was 60.2 years old (46-74 years old). The mean size of the aneurysms was 30 mm (21-34 mm), and 5 patients had partially thrombosed aneurysms. In 5 patients, high flow bypass with an radial artery (RA) graft was performed. In all patients, occlusions of internal carotid arteries and total thrombosis of the aneurysms were observed in the initial MRIs taken the 1 to 15 days after the surgery. In MRIs taken within one month after the surgeries, transient enlargements of the aneurysms were observed in 5 patients. However, the aneurysms began to decrease in size in 3-4 months. In the long-term, we found that the aneurysms markedly decreased in their sizes in 1-2 years, excluding the case with severe calcification of the wall. Non-homogeneous MRI signals were observed in the postoperative thrombosed aneurysms. Even if the aneurysms were completely thrombosed, signal intensity within aneurysms showed various changes during the follow-ups. (author)