Redefining the Carotid Cave in the Evaluation and Management of Paraclinoid Segment Aneurysms

Introduction: The concept of the carotid cave and paraclinoid segment of the internal carotid artery has seen heterogeneous descriptions over the past 40 years with several classifications system and terminology utilized. Aneurysms that occur in this location can be difficult to classify for descriptive purposes, as well as to define risk of subarachnoid hemorrhage and need for treatment. The complex anatomy of this region requires thorough understanding of the course of the internal carotid artery, as well as the dural rings. We utilized incidental paraclinoid aneurysms discovered during surgical dissection, as well as case series to elucidate the anatomy of this region as it pertains to aneurysm surgery.