Anatomical location of carotid cave aneurysms.

Seven carotid cave aneurysms were studied with various imaging techniques and at surgery. The carotid cave aneurysm projects medially with most of it overlying the sella turcica. The aneurysm partially overlies the anterior loop of the cavernous carotid artery and the anterior loop always partially overlies the sella turcica in these cases. The site of the cave aneurysm corresponds well with an area of the carotid artery observed on dissection studies which is adjacent to the sella. This parasellar area differs from the carotid cave in that it is below the dural ring and is not reinforced by the bone of the carotid sulcus. The findings explain the medial projection of the cave aneurysm in that this is the direction of least resistance which in turn also corresponds with the site of maximal force of the flowing blood.