XXXX during balloon test occlusion of the cervical internal carotid artery. Report of two cases.

@entity1 @entity135 @entity809 @entity425 @entity15265 @entity439 @entity661 @entity432
The authors report the occurrence of ipsilateral transient @entity15265 during balloon test occlusion (BTO) of the cervical internal carotid artery (ICA) and discuss the involved pathomechanisms. The authors reviewed their series of 129 BTOs of the ICA performed between 1989 and 1996. Two @entity1 developed @entity809 and transient palsies of the third through sixth cranial nerves during test occlusion of the cervical ICA. The tests were performed prior to planned permanent @entity432 for the treatment of a @entity135 in one @entity1 and a giant cavernous carotid artery @entity439 in the other. The @entity1 ' symptoms resolved with @entity661 . When the balloon was subsequently inflated above the inferior cavernous sinus artery (ICSA), one of the @entity1 complained of mild facial discomfort. There was no @entity425 or mental status change during test occlusion in either @entity1 . Angiography demonstrated good filling of the ipsilateral intracranial circulation via collateral vessels of the circle of Willis. In these two cases, the cranial nerves in the cavernous sinus were likely supplied by the ICA via the meningohypophyseal trunk and the ICSA. In each case, there was excellent blood supply to the ipsilateral cerebral hemisphere; however, there was probably inadequate retrograde filling of the cranial nerve collateral vessels located where the meningohypophyseal trunk and ICSA originated. These cases emphasize the importance of a patent external carotid artery-ICA connection for successful cervical @entity432 . Neurological examination during BTO was critical to interpret the clinical manifestations caused by the hemodynamic changes.
