An unusual presentation of “Mirror-Image” bilateral giant carotid cavernous aneurysms: Case report and review of the literature

The almost asymptomatic “mirror-image” bilateral giant intracavernous carotid artery aneurysms are not common and its successful conservative management without further neurological complications is rarely reported.

We report a case of a 64-year-old woman, admitted with a rapidly progressive headache, with no other signs or symptoms associated. The Head CT-Scan shows bilateral parasellar round hyperdense lesions and the Magnetic resonance angiography discloses bilateral giant intracavernous carotid artery aneurysms in detail. The clinical presentation of these types of lesions depends on their mass effect on the surrounding neurovascular structures. So, possibly no mass effect on any structure, then no obvious expected symptoms. A patient with these conditions and without neurological deficit should not be rushed to surgery or endovascular treatment.