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Park and Koo: A Giant Unruptured Aneurysm of Distal Internal Carotid Artery Presenting with Compressive Optic Neuropathy
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1368-1371.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1368

A Giant Unruptured Aneurysm of Distal Internal Carotid Artery Presenting with Compressive Optic Neuropathy

Jae Yeong Park, MD, Nam Kyun Koo, MD

Department of Ophthalmology, Dongkang Medical Center, Ulsan, Korea.

Address reprint requests to Nam Kyun Koo, MD. Department of Ophthalmology, Dongkang Medical Center, #239 Taehwa-ro, Jung-gu, Ulsan 681-711, Korea. Tel: 82-52-241-1331, Fax: 82-52-241-1146, nkkoo77@naver.com

Received 2 March 2012       Accepted 21 July 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of compressive optic neuropathy due to a giant unruptured aneurysm of a distal internal carotid artery.

Case summary

A 68-year-old female presented with a one-week history of visual disturbance in her left eye. The patient had no underlying disease except hypertension. Best corrected visual acuity was 20/20 in the right eye and 8/20 in the left eye. The color perception test showed abnormal findings in the left eye. Slit lamp examination showed no abnormal finding except incipient cataract in both eyes. Additionally, fundus examination showed no abnormal finding. Brain MRI and MRA revealed a 2.4 × 2.2 × 3.0-cm-sized unruptured giant aneurysm on the left internal carotid artery.

Conclusions

A giant aneurysm should be considered as a cause for acute or subacute optic neuropathy in a patient with hypertension.

Keywords: Compressive optic neuropathy, Giant aneurysm

Figures and Tables

Figure 1
Fundus photographs show no abnormal findings in both eyes.
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Figure 2
Humphrey visual field test of both eyes. (A) Right eye shows inferotemporal visual field defect on pattern deviation. (B) Left eye shows constricted peripheral visual field on pattern deviation.
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Figure 3
MR image of both horizontal section and coronal section. (A) MR images shows abnormal signal on horizontal section (arrow). (B) MR images shows abnormal signal compressing the optic chiasm (arrow) on coronal section.
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Figure 4
MR angiogram showing 2.4 × 2.2 × 3.0 cm sized giant intracranial aneurysm of left internal carotid artery (arrow).
jkos-53-1368-g004

References

1. Artmann H, Vonofakos D, Müller H, Grau H. Neuroradiologic and neuropathologic findings with growing giant intracranial aneurysm. Review of the literature. Surg Neurol. 1984. 21:391–401.
2. Horowitz MB, Yonas H, Jungreis C, Hung TK. Management of a giant middle cerebral artery fusiform serpentine aneurysm with distal clip application and retrograde thrombosis: case report and review of the literature. Surg Neurol. 1994. 41:221–225.
3. Sonntag VK, Yuan RH, Stein BM. Giant intracranial aneurysms: a review of 13 cases. Surg Neurol. 1977. 8:81–84.
4. Kim JY, Choi HY. A case of the giant aneurysm in the distal portion of the posterior cerebral artery: A case report. J Korean Neurosurg Soc. 2000. 29:963–967.
5. Sundt TM Jr, Piepgras DG. Surgical approach to giant intracranial aneurysms. Operative experience with 80 cases. J Neurosurg. 1979. 51:731–742.
6. Ellamushi H, Thorne L, Kitchen N. Unruptured cerebral aneurysms causing seizure disorder (report of two cases). Seizure. 1999. 8:310–312.
7. Heros RC, Kolluri S. Giant intracranial aneurysms presenting with massive cerebral edema. Neurosurgery. 1984. 15:572–577.
8. Whittle IR, Dorsch NW, Besser M. Giant intracranial aneurysms: diagnosis, management, and outcome. Surg Neurol. 1984. 21:218–230.
9. Fried LC, Yballe A. Rapid formation of giant aneurysms: case report. J Neurol Neurosurg Psychiatry. 1972. 35:527–530.
10. Koshikawa N, Kamio M, Sekino H, et al. [Giant aneurysm--a case report with review of literature (author's transl)]. No Shinkei Geka. 1980. 8:79–88.
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