A CASE REPORT ON GIANT CAROTID − OPHTHALMIC ARTERY ANEURYSM
Abstract
Ophthalmic artery (OA) is a potential origin of aneurysms. We present a patient with a giant OA aneurysm, with a sudden onset of psychomotor agitation at the admission. Digital subtraction angiography showed an aneurysm originating from the ophthalmic segment of the left internal carotid artery of irregular shape, with diameters up to 6.5 x 4.5 mm, while the neck of the aneurysm was 4 mm wide. On computed tomography angiography, the aneurysm was seen as much larger and round, up to 4.7 cm in diameter and with a calcified wall. In the further course of treatment, the microcatheter was placed in the lumen of the aneurysm and the embolization spirals were set within. This resulted in a complete exclusion of the aneurysm from the circulation. Endovascular treatment for the giant OA aneurysm, such as coil embolization technique, might be successful for the complete exclusion from circulation of a giant and partially thrombosed aneurysm.
References
Charles GD. Giant intracranial aneurysms: experience with surgical treatment in 174 patients. Clin Neurosurg 1979;26:12-95. [CrossRef] [PubMed]
Dinca EB, Brehar F, Giovani A, Ciurea AV. Challenges in a case of ophthalmic artery aneurysm associated with abnormal internal carotid arteries. Asian J Neurosurg 2017;12(1):106. [CrossRef] [PubMed]
Dinca EB, Brehar F, Giovani A, Ciurea AV. Challenges in a case of ophthalmic artery aneurysm associated with abnormal internal carotid arteries. Asian J Neurosurg 2017;12(1):106. [CrossRef] [PubMed]
Dowd CF, Halbach VV, Higashida RT, Barnwell SL, Hieshima GB. Endovascular coil embolization of un-usual posterior inferior cerebellar artery aneurysms. Neurosurgery 1990;27(6):954-61. [CrossRef] [PubMed]
Drake CG. Progress in cerebrovascular disease. Management of cerebral aneurysm. Stroke 1981;12: 273-83. [CrossRef] [PubMed]
Fox AJ, Viñuela F, Pelz DM, et al. Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms. J Neurosurg 1987; 66(1):40-6. [CrossRef] [PubMed]
Fulkerson DH, Horner TG, Payner TD, et al. Results, outcomes, and follow-up of remnants in the treatment of ophthalmic aneurysms: a 16-year experience of a combined neurosurgical and endovascular team. Neurosurgery 2009;64(2):218-29. [CrossRef] [PubMed]
Giannotta SL, McGillicuddy JE, Kindt GW. Gradual carotid artery occlusion in the treatment of in-accessible internal carotid artery aneurysms. Neuro-surgery 1979;5(4):417-21. [CrossRef] [PubMed]
Heran NS, Song JK, Kupersmith MJ, et al. Large ophthalmic segment aneurysms with anterior optic pathway compression: assessment of anatomical and visual outcomes after endosaccular coil therapy. J Neurosurg 2007;106(6):968-75. [CrossRef] [PubMed]
Hosobuchi Y. Direct surgical treatment of giant intracranial aneurysms. J Neurosurg 1979;51(6):743-56. [CrossRef] [PubMed]
Kamide T, Tabani H, Safaee MM, Burkhardt JK, Lawton MT. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms. J Neurosurg 2018;129(6):1511-21. [CrossRef] [PubMed]
Kanagalingam S, Gailloud P, Tamargo RJ, Subramanian PS, Miller NR. Visual sequelae after consensus-based treatment of ophthalmic artery seg-ment aneurysms: the Johns Hopkins experience. J Neuroophthalmol 2012;32(1):27-32. [CrossRef] [PubMed]
Katayama S, Fujita K, Takeda N, Okamura Y. Stent graft placement for the treatment of giant aneurysm at the proximal cavernous internal carotid artery. A case report. Interv Neuroradiol 2006;12(Suppl 1): 117-20. [CrossRef] [PubMed]
Lv X, Jiang C, Li Y, Yang X, Zhang J, Wu Z. Treatment of giant intracranial aneurysms. Interv Neuroradiol 2009;15(2):135-44. [CrossRef] [PubMed]
Meling TR, Sorteberg W, Bakke SJ, Jacobsen EA, Lane P, Vajkoczy P. Case report: a troublesome ophthalmic artery aneurysm. J Neurol Surg Rep 2014;75(02): e230-5. [CrossRef] [PubMed]
Nurminen V, Lehecka M, Chakrabarty A, Kivisaari R, Lehto H, Niemela M, et al. Anatomy and morphology of giant aneurysms-angiographic study of 125 consecutive cases. Acta Neurochir (Wien) 2014;156: 1-10. [CrossRef] [PubMed]
Serafin Z, Strześniewski P, Lasek W, Beuth W. Follow-up after embolization of ruptured intracranial ane-urysms: a prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonance angiography. Neuroradiology 2012;54(11):1253-60. [CrossRef] [PubMed]
Streefkerk HJ, Wolfs JF, Sorteberg W, Sorteberg AG, Tulleken CA. The ELANA technique: constructing a high flow bypass using a non-occlusive anastomosis on the ICA and a conventional anastomosis on the SCA in the treatment of a fusiform giant basilar trunk aneurysm. Acta Neurochir (Wien) 2004;146(9):1009-19. [CrossRef] [PubMed]