Interdisciplinary Neurosurgery (Sep 2023)
Successful Treatment of Optic Nerve Splitting secondary to an Internal Carotid Artery Ophthalmic Segment Aneurysm: case report and literature review
Abstract
Background: Ophthalmic segment aneurysms that divide the optic nerve are exceedingly rare. We present a unique case of asymptomatic optic nerve splitting secondary into internal carotid artery ophthalmic segment aneurysm that was successfully treated with flow diversion.Case Description: A 58-year-old female presented to an outside hospital with an intermittent “rubbing sound” in her right ear. Imaging was remarkable for a left anterior skull base meningioma and a left internal carotid artery ophthalmic segment aneurysm. Humphrey visual field testing confirmed lack of scotoma or visual deficit. Intraoperatively, during craniotomy for resection of the meningioma, the aneurysm dome was noted to be splitting the optic nerve with a thin layer covering the dome.Given that the patient was asymptomatic and had intact visual function, it was decided that flow diversion would be safer option than clipping to avoid any optic nerve manipulation. On follow up, the patient remained free of visual impairment with an occluded aneurysm. Conclusion: This case presentation of a unique, asymptomatic ophthalmic segment aneurysm with splitting of the optic nerve, demonstrates successful treatment with flow diversion. It is notable both for the asymptomatic presentation and for highlighting the successful treatment of this kind of aneurysm with flow diversion.
