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A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia

Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large...

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Autores principales: Seung, Won-Bae, Kim, Dae-Yong, Park, Yong-Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Neurosurgical Society 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630364/
https://www.ncbi.nlm.nih.gov/pubmed/26539276
http://dx.doi.org/10.3340/jkns.2015.58.3.291
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author Seung, Won-Bae
Kim, Dae-Yong
Park, Yong-Seok
author_facet Seung, Won-Bae
Kim, Dae-Yong
Park, Yong-Seok
author_sort Seung, Won-Bae
collection PubMed
description Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an 18×8 mm dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy.
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spelling pubmed-46303642015-11-04 A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia Seung, Won-Bae Kim, Dae-Yong Park, Yong-Seok J Korean Neurosurg Soc Case Report Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an 18×8 mm dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy. The Korean Neurosurgical Society 2015-09 2015-09-30 /pmc/articles/PMC4630364/ /pubmed/26539276 http://dx.doi.org/10.3340/jkns.2015.58.3.291 Text en Copyright © 2015 The Korean Neurosurgical Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Seung, Won-Bae
Kim, Dae-Yong
Park, Yong-Seok
A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title_full A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title_fullStr A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title_full_unstemmed A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title_short A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia
title_sort large ruptured anterior communicating artery aneurysm presenting with bitemporal hemianopsia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630364/
https://www.ncbi.nlm.nih.gov/pubmed/26539276
http://dx.doi.org/10.3340/jkns.2015.58.3.291
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