Giant aneurysm of the high internal carotid artery: surgical treatment.

We report the successful surgical treatment of a patient with a giant aneurysm of the high internal carotid artery by resection of the aneurysm and end-to-end anastomosis at the skull base, after resection of the styloid process and section of the stylohyoid and digastric muscles. No shunt was used and no major neurologic deficits resulted. Thirty months after operation the repaired artery is patent, with no evidence of stenosis or residual aneurysm and with good distal perfusion. Surgical treatment of high carotid artery aneurysms is possible with rather simple techniques; excision of the aneurysm followed by restoration of continuity of the carotid ends should be the treatment of choice regardless of the location of the aneurysm.