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Abstract #45793 Published in IGR 13-2
Bilateral supraclinoid aneurysms associated with progressive visual loss
Carmen Garcia M; Canovas D; Marco M; Hervas M; Estela J; Ribera GNeuro-Ophthalmology 2011; 35: 43
INTRODUCTION: Aneurysms of the internal carotid artery represent 4% of cerebral aneurysms. Aneurysms located in the supraclinoid segments are a relatively common reason for progressive visual loss, sometimes associated with ophthalmoplegia due to compression of the visual pathway or the motor ocular nerves. OBJECTIVES: To present a case with bilateral carotid aneurysms associated with progressive visual loss. RESULTS: A 49-year-old woman without precedents of interest that is visited by neurologist because of slowly progressive loss of visual acuity in the last five years. On neurologic examination she had bilateral optic disc pallor and loss of peripheral visual field, without oculomotor nerve paresis or facial hypoesthesia. She was initially diagnosed of glaucoma and topical medications with prostaglandin analogues were prescribed. A cranial RMI demonstrated the presence of bilateral supraclinoid carotid aneurysms with compression of the optic nerves. An angiography confirmed the existence of these aneurysms over the exit of the ophthalmic artery. COMMENTS AND CONCLUSIONS: Supraclinoid aneurysms of the carotid artery are one of the potentially treatable causes of visual progressive loss. Near 10 % of them present with neurological signs associated with effect of mass, such as headache or visual deficit. The examination of the visual system is of great value for the diagnosis of neurological affections. The magnetic resonance should be the choice method of election when a compressive injury of the visual pathway is suspected, especially around optic chiasm.
M. Carmen Garcia. Hospital Parc Tauli, Sabadell, Spain.
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
2.16 Chiasma and retrochiasmal central nervous system (Part of: 2 Anatomical structures in glaucoma)
