+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Long term visual and neurological prognosis in patients with treated and untreated cavernous sinus aneurysms

Long term visual and neurological prognosis in patients with treated and untreated cavernous sinus aneurysms

Journal of Neurology, Neurosurgery, and Psychiatry 75(6): 863-867

Objective: To determine the long term visual and neurological outcome of patients diagnosed with cavernous sinus aneurysms (CCAs). Methods: Prospective follow up for at least five years or until death of 31 retrospectively recruited patients (27 women, 4 men) with treated and untreated CCAs. Results: There were 40 aneurysms in all. Mean age at diagnosis was 60.4 years (range 25 to 86; median 64). The most common symptoms were diplopia (61%), headache (53%), and facial or orbital pain (32%). Fifteen patients (48%) were diagnosed after they developed cranial nerve pareses, four (13%) after they developed carotid-cavernous sinus fistulas (CCFs), and 12 (39%) by neuroimaging studies done for unrelated symptoms. Twenty one patients (68%) had treatment to exclude the aneurysm from circulation, 10 shortly after diagnosis and 11 after worsening symptoms. Immediate complications of treatment occurred in six patients and included neurological impairment, acute ophthalmoparesis, and visual loss. Ten patients (32%) were observed without intervention. Over a mean (SD) follow up period of 11.8 (7.7) years, eight had improvement in symptoms, five remained stable, and eight deteriorated. Among the 10 patients followed without intervention, none improved spontaneously, three remained stable, and seven worsened. Conclusions: Most treated patients in this series improved or remained stable after treatment, but none improved without treatment. The long term prognosis for treated cases is relatively good, with most complications occurring immediately after the procedure. Endovascular surgery has decreased the morbidity and mortality of treatment so should be considered for any patient with a CCA.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 012271123

Download citation: RISBibTeXText

PMID: 15146001

DOI: 10.1136/jnnp.2003.020917

Related references

Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms. Journal of Neurology Neurosurgery and Psychiatry 84(8): 888-892, 2013

Long-term visual outcome after nonradical microsurgery in patients with parasellar and cavernous sinus meningiomas. Neurosurgery 47(1): 24-32, 2000

Long-term prognosis in patients with clipped unruptured cerebral aneurysms--increased cerebrovascular events in patients with surgically treated unruptured aneurysms. Neurosurgical Review 36(4): 567, 2013

Long-term follow-up study of patients with cavernous sinus aneurysm treated by proximal occlusion. Neurologia Medico-Chirurgica 40(2): 88-96; Discussion 96-7, 2000

Long Term Prognosis and Insurability in Patients with Congenital Cardiac Defects Treated Surgically or Untreated. American Journal of Cardiology 13: 645-649, 1964

The long-term prognosis in untreated cerebral aneurysms: I. The incidence of late hemorrhage in cerebral aneurysm: a 10-year evaluation of 364 patients. Annals of Neurology 1(4): 358-370, 1977

Long-term prognosis of a group of patients with ruptured intracranial aneurysms not treated surgically. Acta Neurologica 30(6): 638-643, 1975

The long-term prognosis in untreated cerebral aneurysms: II. Late morbidity and mortality. Annals of Neurology 4(5): 418-426, 1978

Long-term prognosis of patients with chronic post-infarct aneurysms. II. Comparison of patients treated conservatively and surgically. Casopis Lekaru Ceskych 128(6): 161-164, 1989

Long-term prognosis of surgically-treated aortic aneurysms and dissections in patients with and without Marfan syndrome. European Journal of Cardio-Thoracic Surgery 13(4): 416-423, 1998

Long-term visual outcome in patients treated by flow diversion for carotid-ophthalmic aneurysms. Journal of Neurointerventional Surgery 10(11): 1067-1073, 2018

The prognosis in long term treated and "untreated" essential hypertension. Acta Medica Scandinavica 185(4): 253-258, 1969

The prognosis in long-term treated and "untreated" essential hypertension. Tidsskrift for den Norske Laegeforening 88(14): 1410-1416, 1968

Suprasellar meningiomas: Neurological and visual outcome at long term follow-up in a homogeneous series of patients treated microsurgically. Acta Neurochirurgica 140(12): 1231-1238, 1998

Suprasellar meningiomas--neurological and visual outcome at long-term follow-up in a homogeneous series of patients treated microsurgically. Acta Neurochirurgica 140(12): 1231-1238, 1998