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Eriko Fujiwara, Toru Mizuki, Shuji Hayashi; Optic Neuropathy after Intracranial Aneurysm Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3884.
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To report five cases of optic neuropathy that developed after intracranial aneurysm surgery.
Five women at the Hakujyuji Hospital were diagnosed with postoperative optic neuropathy after undergoing clipping or wrapping of intracranial aneurysms.
Four of the patients had a ruptured aneurysm, and one had two intact aneurysms. The average age of the patients was 61 (range, 44 to 76) years. The aneurysm was located on the anterior communicating artery (AcomA; n=1), the middle cerebral artery (MCA; n=2), on both the AcomA and the MCA (n=1), or at the junction of the internal carotid and posterior communicating arteries (ICA-PoCA; n=1). Three patients underwent clipping of a ruptured aneurysm, and a ruptured aneurysm clipping of the ICA-PoCA and superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis underwent in one patient. One patient who had two unruptured aneurysms underwent clipping of the AcomA and wrapping of the MCA. Of these patients, four had an onset of visual loss within 3 to 14 days after the clipping, and one patient who had both clipping and wrapping of the aneurysms had an onset of visual decrease 45 days after the surgery. Systemic corticosteroid therapy was given to two patients because of suspected ischemic optic neuropathy, and one patient had an improvement in her vision. The visual acuity after the optic neuropathy ranged from blindness to 1.2. One patient had an infectious brain abscess 45 days after surgery by wrapping of a MCA aneurysm. A compression optic neuropathy was found in both eyes of one case whose MRI scan showed hyperintense signal in both optic tracts on the T2-weighted and fluid-attenuated inversion recovery (FLAIR) studies.
It is important to be aware that optic neuropathy can develop after intracranial aneurysm surgery.
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