scholarly journals Intraorbital aneurysm of the ophthalmic artery

2019 ◽  
Vol 12 (4) ◽  
pp. e227044
Author(s):  
Pavitra Garala ◽  
Jasvir Virdee ◽  
Madyan Qureshi ◽  
Timothy Gillow
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Conservative Treatment ◽  
Renal Impairment ◽  
Ophthalmic Artery ◽  
Low Risk ◽  
Nerve Function ◽  
Conservative Approach ◽  
Risk Of Rupture ◽  
Visual Disturbances

Intraorbital ophthalmic artery (OA) aneurysms are rare. They can be asymptomatic or present with visual disturbances, exophthalmos and headaches. We present a case of a 57-year-old man who presented with reduced vision, diplopia and exophthalmos. A carotid artery angiogram identified a right OA aneurysm. Due to the low risk of rupture and the patient’s comorbidities including cardiac and renal impairment, a conservative approach was followed. A few weeks post presentation, the patient’s vision and optic nerve function had improved. This case reiterates the importance of considering conservative treatment for patients with intraorbital OA aneurysms.

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.

Pathological findings of fusiform dilation of the internal carotid artery following radical dissection of a craniopharyngioma

2010 ◽  
Vol 6 (6) ◽  
pp. 567-571 ◽  
Author(s):  
Takashi Nagata ◽  
Takeo Goto ◽  
Tsutomu Ichinose ◽  
Yutaka Mitsuhashi ◽  
Naohiro Tsuyuguchi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Radical Resection ◽  
Low Risk ◽  
Pathological Findings ◽  
Pathological Result ◽  
Risk Of Rupture ◽  
Histopathological Evaluation ◽  
Radical Dissection

Fusiform dilation of the internal carotid artery (FDICA) after radical resection of a suprasellar craniopharyngioma has been reported. To the authors' knowledge, however, fatal conditions associated with FDICA have not been reported and pathological findings have not been obtained. The authors performed biopsy sampling of the wall of an FDICA for histopathological evaluation and found hyperplastic adventitia. This pathological result strongly supports conclusions from previous reports that FDICA has a low risk of rupture.

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.

scholarly journals Basilar artery origin of an orbital artery – A rare variant and review of the embryology of the orbital arterial supply

2020 ◽  
Vol 26 (5) ◽  
pp. 668-674
Author(s):  
Pervinder Bhogal ◽  
Cindy Richter ◽  
Stefan Schob ◽  
Muhammad AlMatter ◽  
Victoria Hellstern ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Rare Variant ◽  
Basilar Artery ◽  
Ophthalmic Artery ◽  
External Carotid Artery ◽  
Point Of View ◽  
Arterial Supply ◽  
External Carotid ◽  
First Case

We present a patient with separation of the arterial supply to the globe and the extra-ocular muscles. The ophthalmic artery originates from the typical adult location and supplies only the globe. Arising from the basilar artery was a branch that supplies the extra-ocular muscles. There was no apparent connection between these vessels around the optic nerve and no evidence of supply from the external carotid artery. We discuss the embryology of the ophthalmic artery from the point of view of Padget and Lasjaunias and offer our opinion on the on-going controversy. We believe this is the first case to highlight the trigeminal-primitive maxillary-stapedial anastamotic pathway.

scholarly journals Endovascular treatment of traumatic carotid pseudoaneurysm with Tubridge flow diverter: A case report

2019 ◽  
Vol 25 (6) ◽  
pp. 685-687 ◽  
Author(s):  
Yazhou Yan ◽  
Yina Wu ◽  
Kaijun Zhao ◽  
Yuan Pan ◽  
Qinghai Huang
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Flow Diverter ◽  
Risk Of Rupture ◽  
Traumatic Pseudoaneurysm ◽  
Rare Lesion ◽  
Flow Diverters

Traumatic pseudoaneurysm is a rare lesion with a high risk of rupture, and represents one of the most difficult lesions to treat, either surgically or endovascularly. Herein, we describe the case of a 32-year-old man with a traumatic pseudoaneurysm of the internal carotid artery, which was treated by overlapped flow diverters (Tubridge). The patient recovered well, and the follow-up angiography at four months showed complete occlusion of the pseudoaneurysm and patency of the internal carotid artery and the ophthalmic artery.

scholarly journals Rare Clinical Onset of Nontraumatic Intracavernous Aneurysm of the Internal Carotid Artery: A Diagnostic and Therapeutic Challenge

2020 ◽  
Author(s):  
Enzo Emanuelli ◽  
Maria Baldovin ◽  
Claudia Zanotti ◽  
Sara Munari ◽  
Luca Denaro ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Arterial Injury ◽  
Sphenoidal Sinus ◽  
Therapeutic Challenge ◽  
Cavernous Sinus Syndrome ◽  
Sellar Lesions ◽  
Risk Of Rupture

AbstractWhile the so-called pseudoaneurysms can result from arterial injury during trans-sphenoidal surgery or after a trauma, spontaneous aneurysms of cavernous–internal carotid artery (CICA) are rare. Symptoms vary and the differential diagnosis with other, more frequent, sellar lesions is difficult. We describe three cases of misdiagnosed CICA spontaneous aneurysm. In two cases the onset was with neuro-ophthalmological manifestations, classifiable as “cavernous sinus syndrome.” The emergency computed tomography scan did not show CICA aneurysm and the diagnosis was made by surgical exploration. The third patient came to our attention with a sudden severe unilateral epistaxis; endonasal surgery revealed also in this case a CICA aneurysm, eroding the wall and protruding into the sphenoidal sinus. When the onset was with a cavernous sinus syndrome, misdiagnosis exposed two patients to potential serious risk of bleeding, while the patient with epistaxis was treated with embolization, using coils and two balloons. Intracavernous nontraumatic aneurysms are both a diagnostic and therapeutic challenge, because of their heterogeneous onset and risk of rupture, potentially lethal. Intracavernous aneurysms can be managed with radiological follow-up, if asymptomatic or clinically stable, or can be surgically treated with endovascular or microsurgical techniques.

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