Junctional Chiasmatic Syndrome Due to Large Anterior Communicating Artery Aneurysm

ABSTRACT Even though aneurysm involving the anterior communicating artery (A Com A) was common in clinical practice, producing compressive symptoms such as visual loss was rare. We report a case, in which patient had gradually progressive visual loss with features of the junctional chiasmatic syndrome, imaging revealed partially thrombosed large A Com A aneurysm. Intraoperatively, aneurysm was found compressing the optic chiasm and right optic nerve, following clipping and decompression of the optic nerve and chiasm there was gradually improvement in the vision over 2 weeks postoperatively.

[1]  Y. Park,et al.  A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia , 2015, Journal of Korean Neurosurgical Society.

[2]  Sang Keun Park,et al.  Anterior communicating artery aneurysm related to visual symptoms. , 2009, Journal of Korean Neurosurgical Society.

[3]  J. D. de Oliveira,et al.  Intracranial aneurysms presenting with mass effect over the anterior optic pathways: neurosurgical management and outcomes. , 2009, Neurosurgical focus.

[4]  J. Huh,et al.  Surgically Treated Anterior Communicating Artery Aneurysm , 2005 .

[5]  K. Shimizu,et al.  Ischemic Optic Neuropathy Associated with Subarachnoid Hemorrhage after Rupture of Anterior Communicating Artery Aneurysm , 2003, Ophthalmologica.

[6]  Y. Sakurai,et al.  Clinical manifestations, character of aneurysms, and surgical results for unruptured cerebral aneurysms presenting with ophthalmic symptoms. , 2002, Acta neurochirurgica. Supplement.

[7]  I. Date,et al.  Cerebral aneurysms causing visual symptoms: their features and surgical outcome , 1998, Clinical Neurology and Neurosurgery.

[8]  W. Hoyt,et al.  Pathogenesis of acute monocular blindness from leaking anterior communicating artery aneurysms , 1997, Neurology.

[9]  F. Afshar,et al.  Visual failure following subarachnoid haemorrhage from rupture of an anterior communicating artery aneurysm. , 1991, Journal of Neurology Neurosurgery & Psychiatry.

[10]  N. Aoki.  Partially thrombosed aneurysm presenting as the sudden onset of bitemporal hemianopsia. , 1988, Neurosurgery.

[11]  G. Ferguson,et al.  Carotid-ophthalmic aneurysms: visual abnormalities in 32 patients and the results of treatment. , 1981, Surgical neurology.

[12]  J. Haase,et al.  Giant anterior communicating artery aneurysm with bitemporal hemianopsia: case report. , 1981, Neurosurgery.

[13]  G. Jefferson.  Further concerning compression of the optic pathways by intracranial aneurysms. , 1953, Clinical neurosurgery.