Inflow Angle of Small Paraophthalmic Aneurysms Is a Determinant of Adjacent Sphenoid Bone Remodeling

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Large internal carotid artery aneurysms can cause remodeling of the sphenoid bone with subsequent hemorrhage into the sinus. No reports have demonstrated small unruptured lesions causing similar bone remodeling. The purpose of this study was to demonstrate our experience with small unruptured paraophthalmic aneurysms causing sphenoid bone remodeling, specifically when the optimal aneurysm inflow angle is present.


We searched our database for computed tomography angiography studies of small paraophthalmic aneurysms and assessed adjacent sphenoid bone remodeling and inflow angle.


We found that aneurysms causing sphenoid remodeling represent 19.51% of all small paraophthalmic aneurysms at our institution and that the average inflow angle for these aneurysms was 94.38 degrees, significantly greater than for those not causing remodeling.


Our findings add support to using computed tomography angiography in the follow-up of aneurysms to assess surrounding bone changes and to the development of a more evidence-based approach in the management of small paraophthalmic aneurysms, which currently may be managed conservatively.

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