Images in Neurosurgery

A 46-year-old male presented to ophthalmology and otolaryngology for treatment of left orbital cellulitis and bilateral sinusitis after dental abscess. Post-operative day one, patient was noted to have right-sided ophthalmoplegia. CT-Angiography (A) and subsequent formal angiography (B) demonstrated a large pseudoaneurysm filling the entire right cavernous sinus. The patient underwent placement of a flowdiverting stent (C) from the proximal cavernous ICA to the ICA terminus (arrows). Contrast stasis persisting well into the venous phase on post-stent injection predicts high likelihood of treatment success.

Submitted by:

Michael J. Lang, MD 

Thomas Jefferson University

Chengyuan Wu, MD

Thomas Jefferson University