Bilateral cavernous carotid aneurysms: Atypical presentation of a rare cause of mass effect. A case report and a review of the literature

Delia Gagliardi, Irene Faravelli, Luisa Villa, Guglielmo Pero, Claudia Cinnante, Roberta Brusa, Eleonora Mauri, Laura Tresoldi, Francesca Magri, Alessandra Govoni, Nereo Bresolin, Giacomo P. Comi, Stefania Corti

Research output: Contribution to journalArticle


Bilateral cavernous carotid aneurysms (CCAs) represent a rare medical condition that can mimic other disorders. We present a rare case of bilateral CCAs simulating an ocular myasthenia. A 76-year-old woman presented with a history of fluctuating bilateral diplopia and unilateral ptosis, which led to the suspicion of ocular myasthenia. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain showed the presence of large bilateral aneurysms of the carotid cavernous tract. After an unsuccessful attempt with steroid therapy, the patient underwent endovascular treatment, with mild improvement. Bilateral CCAs can cause pupil sparing third nerve palsies and other cranial neuropathies which can mimic signs and symptoms of disorders of the neuromuscular junction. Therefore, the possibility of a vascular lesion simulating ocular myasthenia should be considered especially in older patients.

Original languageEnglish
Article number619
JournalFrontiers in Neurology
Issue numberAUG
Publication statusPublished - Aug 2 2018



  • Bilateral cavernous carotid aneurysms
  • Cranial nerves palsy
  • Diplopia
  • Internal carotid artery
  • Pseudomyasthenia

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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