[Arterial aneurysms of the petrous portion of the carotid artery].

The authors report on 3 patients with arterial aneurysms of the petrous part of the carotid artery which in 2 of them were manifested by profuse recurrent hemorrhages from the external acoustic meatus. The aneurysm was caused by penetrating injury of the middle ear in one patient and injury inflicted during surgery on the middle ear for purulent otitis and mastoiditis in another. Hemorrhages in the third patient occurred during exacerbation of chronic purulent inflammation of the middle ear. The diagnosis of aneurysm was made by cerebral angiography in combination with the method of substruction of the temporal bone structures. In 2 patients with aneurysms of this localization which is difficult for access were completely excluded from circulation by the endovascular method using a balloon catheter. The third patient was not operated on because of spontaneous thrombosis of the cervical segment of the carotid artery. The authors analyse the pathogenesis, clinical course, diagnosis and methods for the management of such aneurysms. They claim that the endovascular method with use of a balloon catheter is most effective for arresting the flow of blood through aneurysms of such localization and for arresting profuse hemorrhages from the external acoustic meatus.