Intracavernous aneurysms make up approximately 5% of all intracranial aneurysms. Their location makes them notoriously difficult to treat. Management of such lesions has evolved over the past decade through a better understanding of their natural history and advances in endovascular techniques. At the present time the senior author relies on bypasses and endovascular therapy rather than direct surgery for aneurysms confined to the cavernous sinus. We still favor intracavernous operations for paraclinoid aneurysms and small intracavernous aneurysms with extracavernous components.
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