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December 1967

Massive Enlargement of Intracranial Aneurysms Following Carotid Ligation

Author Affiliations

Brooklyn, NY
From the Division of Neurosurgery, Department of Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY.

Arch Neurol. 1967;17(6):609-613. doi:10.1001/archneur.1967.00470300051009

ACCUMULATED experiences over the past 15 years have established carotid ligation as one of the suggested treatments for intracranial aneurysms.1-7 It has been estimated that a 20% to 50% drop of late intra-arterial pressure is necessary to induce eventual and complete thrombosis of the aneurysm.6,7 If the thrombosis becomes incomplete, we believe a process of enlargement by lamination could occur.

Report of Cases  CASE 1.—A 54-year-old right-handed white man was first admitted to the Kings County Hospital Center on May 22, 1963, because of headache, vomiting and left hemiparesis. The headache occurred episodically over several years and was relieved by aspirin. An acute episode of headache and vomiting resulted in a fall which prompted his entry into the hospital. The pertinent findings at this time were a stiff neck, lethargy, early papilledema, a mild left central facial paresis and left hemiparesis. The cerebrospinal fluid contained blood,

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