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Proper ophthalmic artery aneurysms

BACKGROUND: The ophthalmic segment of the internal carotid artery (ICA) represents a common site for cerebral aneurysms. However, aneurysms of the ophthalmic artery (OphA) itself represent rare lesions and have been associated with trauma and flow-related lesions such as arteriovenous fistulas or ma...

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Autores principales: Hendrix, Philipp, Bohan, Christian, Dalal, Shamsher Singh, Weiner, Gregory M., Kanmounye, Ulrick S., Schirmer, Clemens M., Goren, Oded
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070312/
https://www.ncbi.nlm.nih.gov/pubmed/37025535
http://dx.doi.org/10.25259/SNI_1151_2022
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author Hendrix, Philipp
Bohan, Christian
Dalal, Shamsher Singh
Weiner, Gregory M.
Kanmounye, Ulrick S.
Schirmer, Clemens M.
Goren, Oded
author_facet Hendrix, Philipp
Bohan, Christian
Dalal, Shamsher Singh
Weiner, Gregory M.
Kanmounye, Ulrick S.
Schirmer, Clemens M.
Goren, Oded
author_sort Hendrix, Philipp
collection PubMed
description BACKGROUND: The ophthalmic segment of the internal carotid artery (ICA) represents a common site for cerebral aneurysms. However, aneurysms of the ophthalmic artery (OphA) itself represent rare lesions and have been associated with trauma and flow-related lesions such as arteriovenous fistulas or malformations. Here, we explore clinical and radiological features of four patients managed for five proper ophthalmic artery aneurysms (POAAs). METHODS: Patients undergoing diagnostic cerebral angiogram (DCA) between January 2018 and November 2021 with newly or previously identified POAA were retrospectively reviewed. Clinical and radiological data were analyzed to identify common and unique features. RESULTS: Four patients with identification of five POAA were identified. Three patients suffered traumatic brain injury with subsequent identification of POAA on DCA. Patient 1 presented with a traumatic carotid-cavernous-sinus fistula requiring transvenous coil embolization and second stage flow diversion of the ICA. Patient 2 suffered a gunshot wound with ICA compromise, ethmoidal dural arteriovenous fistula (dAVF) development with rapid growth of two POAAs eventually requiring Onyx embolization. Patient 3 was assaulted and DCA showed a POAA without any other cerebrovascular pathology. Patient 4 had undergone N-butyl cyanoacrylate embolization of an ethmoidal dAVF 13 years ago with the feeding OphA carrying a large POAA. Re-DCADCA was performed for a newly developed and unrelated transverse-sigmoid-sinus dAVF. CONCLUSION: Management of POAAs poses a challenge to neurovascular surgeons since POAAs inherit a risk for visual deterioration or hemorrhage. DCA facilitates identification of coexisting cerebrovascular pathology. If clinically silent and not accompanied by cerebrovascular disease, observation appears reasonable.
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spelling pubmed-100703122023-04-05 Proper ophthalmic artery aneurysms Hendrix, Philipp Bohan, Christian Dalal, Shamsher Singh Weiner, Gregory M. Kanmounye, Ulrick S. Schirmer, Clemens M. Goren, Oded Surg Neurol Int Original Article BACKGROUND: The ophthalmic segment of the internal carotid artery (ICA) represents a common site for cerebral aneurysms. However, aneurysms of the ophthalmic artery (OphA) itself represent rare lesions and have been associated with trauma and flow-related lesions such as arteriovenous fistulas or malformations. Here, we explore clinical and radiological features of four patients managed for five proper ophthalmic artery aneurysms (POAAs). METHODS: Patients undergoing diagnostic cerebral angiogram (DCA) between January 2018 and November 2021 with newly or previously identified POAA were retrospectively reviewed. Clinical and radiological data were analyzed to identify common and unique features. RESULTS: Four patients with identification of five POAA were identified. Three patients suffered traumatic brain injury with subsequent identification of POAA on DCA. Patient 1 presented with a traumatic carotid-cavernous-sinus fistula requiring transvenous coil embolization and second stage flow diversion of the ICA. Patient 2 suffered a gunshot wound with ICA compromise, ethmoidal dural arteriovenous fistula (dAVF) development with rapid growth of two POAAs eventually requiring Onyx embolization. Patient 3 was assaulted and DCA showed a POAA without any other cerebrovascular pathology. Patient 4 had undergone N-butyl cyanoacrylate embolization of an ethmoidal dAVF 13 years ago with the feeding OphA carrying a large POAA. Re-DCADCA was performed for a newly developed and unrelated transverse-sigmoid-sinus dAVF. CONCLUSION: Management of POAAs poses a challenge to neurovascular surgeons since POAAs inherit a risk for visual deterioration or hemorrhage. DCA facilitates identification of coexisting cerebrovascular pathology. If clinically silent and not accompanied by cerebrovascular disease, observation appears reasonable. Scientific Scholar 2023-03-24 /pmc/articles/PMC10070312/ /pubmed/37025535 http://dx.doi.org/10.25259/SNI_1151_2022 Text en Copyright: © 2023 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Hendrix, Philipp
Bohan, Christian
Dalal, Shamsher Singh
Weiner, Gregory M.
Kanmounye, Ulrick S.
Schirmer, Clemens M.
Goren, Oded
Proper ophthalmic artery aneurysms
title Proper ophthalmic artery aneurysms
title_full Proper ophthalmic artery aneurysms
title_fullStr Proper ophthalmic artery aneurysms
title_full_unstemmed Proper ophthalmic artery aneurysms
title_short Proper ophthalmic artery aneurysms
title_sort proper ophthalmic artery aneurysms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070312/
https://www.ncbi.nlm.nih.gov/pubmed/37025535
http://dx.doi.org/10.25259/SNI_1151_2022
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