J Korean Ophthalmol Soc > Volume 53(3); 2012 > Article
Journal of the Korean Ophthalmological Society 2012;53(3):486-491.
DOI: https://doi.org/10.3341/jkos.2012.53.3.486    Published online March 15, 2012.
A Case of Intracavernous Carotid Aneurysm Presenting with Visual Loss with No Oculomotor Disturbance.
Seung Hoon Kim, Sun Woong Kim, Bum Tae Kim, Jee Ho Chang
1Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. jhchang@schmc.ac.kr
2Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
눈운동장애 없이 시력 저하를 보인 해면정맥동 내경동맥류 1예
김승훈1⋅김선웅1⋅김범태2⋅장지호1
Departments of Ophthalmology1 and Neurosurgery2, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Abstract
PURPOSE
Oculomotor disturbance is the common manifestation of intracavernous carotid aneurysm cases. Intracavernous carotid aneurysms causing compressive optic neuropathy with no oculomotor disturbance are relatively rare due to their anatomical characteristics. We experienced a case of intracavernous carotid aneurysm which resulted in a shifted supraclinoid segment of the internal carotid artery, presenting with visual loss and visual field defect with no oculomotor disturbance. CASE SUMMARY: A 40-year-old woman presented with loss of vision in the right eye. A relative afferent pupillary defect was observed in this eye. Visual field test showed quadranopsia in the right eye. Magnetic resonance imaging revealed that the intracavernous carotid aneurysm had shifted the supraclinoid segment of the internal carotid artery to the superomedial position. The right optic nerve was directly molded by the shifted supraclinoid segment of the internal carotid artery at the point of the bifurcation between the anterior cerebral artery and the middle cerebral artery. A Guglielmi detachable coil (GDC) embolization was performed successfully with no operational complications. Six months after coiling, best corrected visual acuity of the right eye was 1.0, and the visual field defect had recovered in all except the superior temporal field. CONCLUSIONS: Oculomotor disturbance is frequently associated with intracavernous carotid aneurysms. Nevertheless, optic neuropathy without oculomotor disturbance may be the only sign in patients with an intracavernous carotid aneurysm that causes shifting of the supraclinoid segment of the internal carotid artery.
Key Words: Cavernous sinus;Internal carotid artery aneurysm;Intracavernous carotid aneurysm;Optic neuropathy;Visual dysfunctions


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