-Review-

Petrous Internal Carotid Artery Aneurysm: A Systematic Review

Yasuo Murai¹, Kazutaka Shirokane¹, Takao Kitamura¹, Kojiro Tateyama¹, Fumihiro Matano¹, Takayuki Mizunari² and Akio Morita¹

¹Department of Neurological Surgery, Nippon Medical School Hospital, Tokyo, Japan
²Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Objective: Petrous internal carotid aneurysm (PA) concomitant with a mass lesion and cranial nerve palsy is relatively rare. Flow-diverter stent implantation is now widely used as an alternative treatment for PA. However, alternative treatments sometimes cannot be used because of tortuosity of the carotid artery, allergies to contrast material, and high costs. The outcomes of different treatment methods should therefore be assessed. Here, we review the available literature on treatments for PA.
Methods: In a search using the terms "aneurysm", "carotid artery", and "petrous" on PubMed, MEDLINE, and databases such as OvidSP, 221 articles were identified. We also performed a literature review and discuss and compare the causes, symptoms, treatment methods, and clinical outcomes of PA.
Results and Conclusions: Onset of secondary aneurysm was generally heralded by bleeding (p<0.001), while onset of primary aneurysm was heralded by cranial nerve deficit (p= 0.0014). Outcomes after treatment of 34 cranial nerve palsies in 25 patients are reported.

J Nippon Med Sch 2020; 87: 172-183

Keywords
cerebral aneurysm, hypoglossal nerve, internal carotid artery, systematic review, petrous

Correspondence to
Yasuo Murai, MD, PhD, Department of Neurological Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
ymurai@nms.ac.jp

Received, December 17, 2019
Accepted, February 26, 2020