A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis

Federico Sacchetti; Silvia Stagni; Luca Spinardi; Luigi Raumer; Nicola Dentale; Luigi Cirillo

doi:10.1016/j.radcr.2016.05.005

A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis

Radiol Case Rep. 2016 Jun 11;11(3):227-33. doi: 10.1016/j.radcr.2016.05.005. eCollection 2016 Sep.

Authors

Federico Sacchetti¹, Silvia Stagni¹, Luca Spinardi², Luigi Raumer³, Nicola Dentale³, Luigi Cirillo⁴

Affiliations

¹ Radiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
² Neuroradiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
³ Division of Infectious Diseases, Department of Internal Medicine, Aging, and Nephrologic Diseases, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
⁴ Neuroradiology Department, IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.

Abstract

We report the uncommon case of an acute cavernous sinus syndrome in a patient who was consequently discovered to have both a cavernous internal carotid artery aneurysm and bacterial meningitis. Which came first, the chicken or the egg? Which of the two, the aneurysm or the meningitis, gave rise to the patient's symptoms? We briefly reviewed the literature of similar cases and tried to analyze the possible pathophysiological relationship between these findings. Moreover, this case highlights the importance of a multidisciplinary management of these patients to better decide between a medical and a surgical and/or endovascular treatment.

Keywords: Bacterial meningitis; Cavernous ICA aneurysm; Cavernous sinus syndrome; DSA; MRI.

Publication types

Case Reports