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Year : 2018  |  Volume : 13  |  Issue : 3  |  Page : 901-905

Recurrent embolic stroke caused by large cavernous carotid aneurysm: Stroke recurrence prevention with high-flow bypass followed by proximal occlusion

1 Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya, Japan
2 Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
3 Department of Neuroendovascular Treatment, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan

Correspondence Address:
Hideaki Ono
Department of Neurosurgery, Fuji Brain Institute and Hospital, 270-12 Sugita, Fujinomiya, Shizuoka 418-0021
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_72_18

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Intracranial aneurysms may cause embolic stroke. Medical or surgical management is selected on an individual basis, as the optimal treatment strategy has not been established. A 79-year-old woman with a large cavernous carotid aneurysm suffered repeated embolic stroke after enlargement and partial thrombosis of the aneurysm, in spite of antiplatelet therapy. Coil embolization of the primitive trigeminal artery and ligation of the internal carotid artery (ICA) at the cervical portion followed by high-flow bypass from the cervical external carotid artery to the middle cerebral artery were performed. The aneurysm was thrombosed, and prevention of further stroke was achieved. Acute enlargement and thrombosis of large or giant cavernous carotid aneurysm may cause repeated embolic stroke, and requires emergent exclusion of the aneurysm from circulation by proximal ICA occlusion together with distal revascularization before devastating embolic stroke occurs.

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