Bacterial aneurysms of the intracavernous carotid artery.

Six cases of bacterial intracavernous carotid artery aneurysms of extravascular origin secondary to cavernous sinus thrombophlebitis are reported along with a review of 12 similar cases collected from the literature. Of the authors' six cases, there were three children and three adults. Meningitis was found in five patients. All patients received prolonged antibiotic therapy. Spontaneous resolution of the aneurysm occurred in one patient, thrombosis of the internal carotid artery in another, and progressive enlargement of the aneurysm was seen on sequential angiography in the other two. Evidence of associated arteritis was present in all of the patients. Carotid ligation for persistent ophthalmoplegia was carried out in two patients, of whom one had a giant aneurysm and the other progressive aneurysm enlargement. The results of treatment were good in all cases. The authors believe that carotid arteriography is obligatory in cases of cavernous sinus thrombophlebitis in which ophthalmoplegia persists despite adequate antibiotic therapy.