{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:05:01Z","timestamp":1782601501879,"version":"3.54.5"},"reference-count":134,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>Most cavernous carotid aneurysms (CCAs) are considered benign lesions, most often asymptomatic, and to have a natural history with a low risk of life-threatening complications. However, several conditions may exist in which treatment of these aneurysms should be considered. Several options are currently available regarding the management of CCAs with resultant good outcomes, namely expectant management, luminal preservation strategies with or without addressing the aneurysm directly, and Hunterian strategies with or without revascularization procedures. In this article, we discuss the sometimes difficult decision regarding whether to treat CCAs. We consider the natural history of several types of CCAs, the clinical presentation, the current modalities of CCA management and their outcomes to aid in the management of this heterogeneous group of cerebral aneurysms.<\/jats:p>","DOI":"10.3171\/2009.2.focus0920","type":"journal-article","created":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T09:57:26Z","timestamp":1241171846000},"page":"E4","source":"Crossref","is-referenced-by-count":63,"title":["Cavernous carotid aneurysms: to treat or not to treat?"],"prefix":"10.3171","volume":"26","author":[{"given":"Christopher S.","family":"Eddleman","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard R.","family":"Bendok","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Hunt","family":"Batjer","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0260004","series-title":"J Neurosurg","first-page":"388","article-title":"The remodeling technique of balloon-assisted Guglielmi detachable coil placement in wide-necked aneurysms: experience at the University of Illinois at Chicago","volume":"93","author":"Aletich","year":"2000"},{"issue":"Suppl 1","key":"b2-0260004","series-title":"Neurol Res","first-page":"S120","article-title":"Influence of stent properties on the alteration of cerebral intra-aneurysmal haemodynamics: flow quantification in elastic sidewall aneurysm models","volume":"27","author":"Barath","year":"2005"},{"key":"b3-0260004","series-title":"J Neurosurg","first-page":"305","article-title":"Retrograde suction decompression of giant paraclinoidal aneurysms. 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Case report","volume":"109","author":"Sudhoff","year":"2000"},{"issue":"2","key":"b57-0260004","series-title":"Neurosurg Focus","first-page":"E21","article-title":"Revascularization for complex intracranial aneurysms","volume":"24","author":"Surdell","year":"2008"},{"key":"b58-0260004","series-title":"Neurosurgery","first-page":"288","article-title":"Common carotid occlusion for unclippable carotid aneurysms: an old but still effective operation","volume":"21","author":"Swearingen","year":"1987"},{"key":"b59-0260004","series-title":"Neuroimaging Clin N Am","first-page":"663","article-title":"Embryology of the cerebral vasculature","volume":"4","author":"Truwit","year":"1994"},{"key":"b60-0260004","series-title":"Stroke","first-page":"313","article-title":"Endovascular treatment of aneurysms in the cavernous sinus: a systematic review on balloon occlusion of the parent vessel and embolization with coils","volume":"33","author":"van der Schaaf","year":"2002"},{"key":"b61-0260004","series-title":"AJNR Am J Neuroradiol","first-page":"185","article-title":"Ruptured cavernous sinus aneurysms causing carotid cavernous fistula: incidence, clinical presentation, treatment, and outcome","volume":"27","author":"van Rooij","year":"2006"},{"key":"b62-0260004","series-title":"Arq Neuropsiquiatr","first-page":"189","article-title":"Presentation and treatment of carotid cavernous aneurysms","volume":"66","author":"Vasconcellos","year":"2008"},{"key":"b63-0260004","series-title":"J Neurol Neurosurg Psychiatry","first-page":"784","article-title":"Carotid cavernous fistula due to a ruptured intracavernous aneurysm of the internal carotid artery: treatment with selective endovascular occlusion of the aneurysm","volume":"71","author":"Wanke","year":"2001"},{"key":"b64-0260004","series-title":"Neuroradiology","first-page":"555","article-title":"A new self-expanding nitinol stent (Enterprise) for the treatment of wide-necked intracranial aneurysms: initial clinical and angiographic results in 31 aneurysms","volume":"49","author":"Weber","year":"2007"},{"key":"b65-0260004","series-title":"AJNR Am J Neuroradiol","first-page":"1909","article-title":"Treatment and follow-up of 22 unruptured wide-necked intracranial aneurysms of the internal carotid artery with Onyx HD 500","volume":"26","author":"Weber","year":"2005"},{"key":"b66-0260004","series-title":"Lancet","first-page":"103","article-title":"Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment","volume":"362","author":"Wiebers","year":"2003"},{"key":"b67-0260004","series-title":"Neurosurgery","first-page":"1234","article-title":"Combined extracranial-intracranial bypass and intraoperative balloon occlusion for the treatment of intracavernous and proximal carotid artery aneurysms","volume":"36","author":"Yonas","year":"1995"},{"key":"b1-0260004","series-title":"J Neurosurg","first-page":"388","article-title":"The remodeling technique of balloon-assisted Guglielmi detachable coil placement in wide-necked aneurysms: experience at the University of Illinois at Chicago","volume":"93","author":"Aletich","year":"2000"},{"issue":"Suppl 1","key":"b2-0260004","series-title":"Neurol Res","first-page":"S120","article-title":"Influence of stent properties on the alteration of cerebral intra-aneurysmal haemodynamics: flow quantification in elastic sidewall aneurysm models","volume":"27","author":"Barath","year":"2005"},{"key":"b3-0260004","series-title":"J Neurosurg","first-page":"305","article-title":"Retrograde suction decompression of giant paraclinoidal aneurysms. 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aneurysms","volume":"12","author":"Javedan","year":"2001"},{"key":"b28-0260004","series-title":"J Neurosurg","first-page":"532","article-title":"Ruptured aneurysm arising from a basilar artery fenestration and associated with a persistent primitive hypoglossal artery. 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