Surgical Treatment of Carotid-Siphon Aneurysms

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Abstract
The direct surgical attack on carotid-siphon aneurysm is hazardous and difficult as compared with other intracranial aneurysms because of its location adjacent to the skull base, the optic nerves and chiasm. The authors report and discuss the surgical treatment of carotid-siphon aneurysms based on our surgical experience of 20 such aneurysms in 18 cases during the period from October 1971 to September 1980. 1. Many aneurysms arising from the C2 carotid-ophthalmic portion of the internal carotid artery can be treated by neck clipping through the pterional approach. It is preferable to clip the neck through a contralateral pterional approach in some cases where the fundus projects posteromedially. 2. For giant aneurysms, it is advisable, along with internal carotid artery trapping, to perform superficial temporal-middle cerebral artery anastomosis. 3. Small aneurysms arising from the C3 or C4 portions of the internal carotid artery will become only faintly visible in angiograms after internal carotid artery ligation with superficial temporal-middle cerebral artery anastomosis, which indicates its effectiveness as a treatment for such aneurysms.

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