Complete Transection of Optic Nerve After Endovascular Coiling of a Large Ophthalmic Artery Aneurysm

2019 ◽  
Vol 132 ◽  
pp. 81-86
Author(s):  
Barbara Verbraeken ◽  
Salah-Eddine Achahbar ◽  
Niels Kamerling ◽  
Laetitia Yperzeele ◽  
Maurits Voormolen ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Complete Transection

Splitting of the optic nerve by a carotid-ophthalmic artery aneurysm

1986 ◽  
Vol 65 (4) ◽  
pp. 560-562 ◽  
Author(s):  
Robert A. Beatty
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Content Type ◽  
Fine Print

✓ A patient with splitting of the optic nerve by a carotid-ophthalmic artery aneurysm is presented. Possible explanations for this previously unreported configuration are discussed.

Intraoperative Awakening for Vision Examination during Ophthalmic Artery Aneurysm Clipping: Technical Case Report

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-E440-ONS-E440 ◽  
Author(s):  
Peng Chen ◽  
Ian F. Dunn ◽  
Linda S. Aglio ◽  
Arthur L. Day ◽  
Kai U. Frerichs ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
The Body ◽  
External Carotid ◽  
Parent Artery ◽  
Nerve Function ◽  
Intraoperative Angiography ◽  
Aneurysm Clipping ◽  
Valuable Adjunct

Abstract OBJECTIVE AND IMPORTANCE: We present a case of a patient with an ophthalmic artery aneurysm in which the ophthalmic artery originated from the body of the aneurysm, requiring sacrifice of the ophthalmic artery to achieve complete aneurysm obliteration. We awakened the patient intraoperatively to assess optic nerve function after clipping and were able to confirm optic nerve function. Controlled intraoperative awakening proved a valuable adjunct to intraoperative angiography in determining the immediate consequences of sacrifice of the ophthalmic artery. CLINICAL PRESENTATION: The patient was a 55-year-old right-handed woman with a 3-month history of episodic blurriness in her left eye; imaging demonstrated an unruptured 5-mm left ophthalmic artery aneurysm in which the ophthalmic artery originated from the body of the aneurysm. INTERVENTION: Complete obliteration of the aneurysm required clip placement across the neck of the aneurysm, incorporating not only the aneurysm but also the ophthalmic artery. Aware that sacrifice of the ophthalmic artery was likely, we awakened the patient after clipping and before dural closure to evaluate her optic nerve function. Once fully awake, the patient was able to execute simple commands and conclusively confirm light perception in both of her eyes. She was then reanesthetized, and intraoperative angiography showed successful aneurysm obliteration and parent artery patency. CONCLUSION: The ophthalmic artery can be sacrificed during aneurysm clipping without loss of vision in many cases, most likely because of adequate collateral filling from the external carotid artery. Certainty about the visual consequences of sacrifice of the ophthalmic artery, however, is difficult to obtain preoperatively or intraoperatively. Intraoperative awakening for evaluation of optic nerve function served as a useful technique to assess the acute results of interruption of ophthalmic artery flow in this case.

Unruptured Ophthalmic Artery Aneurysm Presenting with Vision Loss

2019 ◽  
pp. 61-68
Author(s):  
Harry Van Loveren ◽  
Zeguang Ren ◽  
Pankaj Agarwalla ◽  
Siviero Agazzi
Keyword(s):  
Decision Making ◽  
Ophthalmic Artery ◽  
Vision Loss ◽  
Artery Aneurysm ◽  
Flow Diversion ◽  
Neurological Deficits ◽  
Endovascular Coiling ◽  
Conventional Angiography ◽  
Multiple Treatment ◽  
Technological Advances

Abstract: Intracranial aneurysms pose a significant clinical challenge for cerebrovascular and endovascular neurosurgeons both in treatment decision-making and in the technical aspects. The most important question is whether the aneurysm has ruptured, thereby necessitating urgent treatment. In the unruptured ophthalmic artery aneurysm case with vision loss, the decision to treat rests on understanding the risk of hemorrhage, the success in addressing neurological deficits, and the morbidity of any potential treatment. Computed tomography angiography, conventional angiography, and magnetic resonance imaging are critical and complementary in the diagnosis and management of ophthalmic artery aneurysms, which have also been termed paraclinoid or junctional aneurysms. Due to technological advances, multiple treatment methods are possible, including surgical clipping, endovascular coiling, and flow diversion. Flow diversion is emerging as an effective, less invasive technique with good vision outcomes. This chapter discusses the data behind decision-making, reviews the surgical technique of flow diversion, and emphasizes important aspects of perioperative management.

Optic nerve penetration by a carotico–ophthalmic artery aneurysm

2010 ◽  
Vol 17 (7) ◽  
pp. 931-933 ◽  
Author(s):  
Y.Y. Wang ◽  
N.B. Thani ◽  
T.F. Han
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm

Penetration of the Optic Nerve by an Internal Carotid Artery-Ophthalmic Artery Aneurysm: Case Report and Literature Review

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 996-1000 ◽  
Author(s):  
Andrew Jea ◽  
Mustafa K. Başkaya ◽  
Jacques J. Morcos
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
World Literature ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Nerve Fibers ◽  
Visual Deterioration ◽  
Operative Exploration

Abstract OBJECTIVE AND IMPORTANCE Although it is well known that large or giant internal carotid artery-ophthalmic artery aneurysms can cause visual deficits, penetration and schism of the optic nerve by an aneurysm are very rare. CLINICAL PRESENTATION A 48-year-old man presented with an acute onset of right visual deterioration after an episode of severe headache. Magnetic resonance imaging demonstrated penetration of the right optic nerve by an intracranial aneurysm. Cerebral angiography revealed an internal carotid artery-ophthalmic artery aneurysm of 12 × 7 mm. The aneurysm was directed superomedially and appeared to have a “waist” within the penetration. INTERVENTION Intraoperatively, we observed that part of the aneurysm wall was visible through the optic nerve fibers at the junction with the optic chiasm. CONCLUSION Although there was no direct evidence of subarachnoid hemorrhage on imaging scans or with operative exploration, we think that the patient must have experienced sentinel hemorrhaging, leading to visual deterioration. We describe the case in detail and review the world literature.

Interhemispheric approach for carotid-ophthalmic artery aneurysm clipping

1987 ◽  
Vol 67 (2) ◽  
pp. 293-295 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Content Type ◽  
Aneurysm Clipping ◽  
Interhemispheric Approach ◽  
Aneurysmal Neck ◽  
Fine Print

✓ The author reports a case in which a subchiasmal carotid-ophthalmic artery aneurysm was clipped through a bifrontal interhemispheric approach. This approach is feasible for carotid-ophthalmic artery aneurysms with a variety of anatomical correlations between the optic nerve and the aneurysmal neck.

scholarly journals Regression of a Flow-Related Ophthalmic Artery Aneurysm after Treatment of a Frontal DAVS

2004 ◽  
Vol 10 (3) ◽  
pp. 265-268 ◽  
Author(s):  
T. Andersson ◽  
L. Kihlström ◽  
M. Söderman
Keyword(s):  
Ophthalmic Artery ◽  
Transarterial Embolization ◽  
Specific Treatment ◽  
Artery Aneurysm ◽  
Complete Regression ◽  
Arterial Aneurysm ◽  
Complete Obliteration ◽  
Dural Arteriovenous Shunt ◽  
Flow Situation ◽  
Ethmoidal Artery

We report a case of a frontal dural arteriovenous shunt or fistula (DAVS) adjacent to the left side of the cribriform plate, with bilateral supply from multiple arteries, the most prominent being the dural branches originating from the anterior ethmoidal artery coming from the left ophthalmic artery. Before treatment there was an eight mm flow-related arterial aneurysm proximally on the left ophthalmic artery. After transarterial embolization of the DAVS with N-butyl cyanoacrylate and polyvinyl alcohol, minimal shunting still remained. At follow-up angiography six months after the treatment, the shunt was obliterated and the ophthalmic artery aneurysm had regressed completely. Our case illustrates that complete obliteration of a DAVS may be achieved even though arteriovenous shunting remains at the end of the procedure. Furthermore, a flow-related arterial aneurysm, may not warrant any specific treatment. Elimination of the high flow situation can lead to complete regression of these aneurysms.

Sign in / Sign up

Export Citation Format

Share Document