[Flow diverter treatment for dissecting aneurysm causing cavernous sinus syndrome].

Cavernous sinus syndrome is a combination of unilateral ophthalmoplegia, autonomic dysfunction and sensory loss of the ophthalmic or maxillary branch of the trigeminal nerve. In the case of cavernous sinus syndrome after a head injury, we should consider the possibility of a dissecting aneurysm. In addition to ruptured aneurysms, silent intracranial aneurysms must also be treated if they cause compression symptoms. In our case report, we present a 23-year-old female patient who lost consciousness during a fall, and immediately developed right-sided ptosis, ophthalmoplegia and loss of facial sensation. Angiography confirmed a dissection aneurysm of the right internal carotid artery at the cavernous sinus, which was treated with a flow diverter on the 6th day after the injury. The intervention was uncomplicated and resulted in rapid and complete radiological and clinical healing. Our case report confirms the fact, based on meta-analyses, that dissection aneurysm occurring at the cavernous sinus section of the internal carotid artery can be safely and successfully treated with a flow diverter. If the treatment is carried out as early as possible, all the symptoms of the cavernous sinus syndrome can be resolved, and the ipsilateral ophthalmoplegia and loss of facial sensation can be completely cured within a few days. Orv Hetil. 2023; 164(52): 2074–2078.