When I first saw the title of the article by Choulakian, Drazin and Alexander1 in the December 2010 JNIS, I thought that I had misread it. Indeed, who has experience treating over 100 cavernous carotid aneurysms (CCAs)? I went on to read, with dismay, the description of treatment of what most commonly should be regarded as ‘do not touch’ lesions. In the authors' defense, three of the 113 patients treated did present with subarachnoid hemorrhage (SAH), and these clearly merit treatment. Regarding the 29 patients presenting with diplopia, one could debate whether treatment is necessary or even helpful; the authors cite articles on the subject but fail to mention that in …