Journal article - Video
Macrovascular Decompression of the Optic Nerve: Technical Case Instruction: 2-Dimensional Operative Video
Operative neurosurgery (Hagerstown, Md.), Vol.30(2), pp.332-332
02/2026
DOI: 10.1227/ons.0000000000001607
PMID: 40323066
Abstract
Compression of the optic nerve through an ectatic internal carotid artery is a rare clinical entity that can lead to unexplained optic neuropathy. We present the case of a 69-year-old woman who presented with the progressive left eye vision loss over 2 years. Neuro-ophthalmology evaluation found a relative apparent pupillary defect with significant visual loss. Imaging revealed an ectatic left internal carotid artery resulting in compression of the left optic nerve resulting in significant thinning. Treatment options were discussed, and macrovascular decompression or no treatment was considered. After an explanation of the intended benefits of the procedure as well as the risks, she confirmed understanding of the procedure and signed a written consent for the procedure. Institutional Review Board approval was not required, and the patient consented to the publication of the images and video.
The patient underwent a left mini-pterional craniotomy with macrovascular decompression of the optic nerve using a sling transposition technique. Postoperative computed tomography angiography confirmed placement of the clip, patency of the vessels, and new location of the internal carotid artery. At follow-up, the patient's progressive vision loss had stopped and stabilized. This case demonstrates the utility of a sling transposition technique in achieving a satisfactory decompression of the optic nerve in this rare pathology, and, to our knowledge, this is the first known surgical video describing this technique for this pathology.
Details
- Title: Subtitle
- Macrovascular Decompression of the Optic Nerve: Technical Case Instruction: 2-Dimensional Operative Video
- Creators
- Shravan AtluriEthan ClineAnthony GuidottiMario Zanaty - University of IowaOndrej Choutka - Department of Neurosurgery, Saint Alphonsus Medical Group, Trinity Healthcare System, Boise, Idaho, USA
- Resource Type
- Journal article
- Resource Sub-type
- Video
- Publication Details
- Operative neurosurgery (Hagerstown, Md.), Vol.30(2), pp.332-332
- DOI
- 10.1227/ons.0000000000001607
- PMID
- 40323066
- NLM abbreviation
- Oper Neurosurg (Hagerstown)
- ISSN
- 2332-4252
- eISSN
- 2332-4260
- Publisher
- Wolters Kluwer Health
- Language
- English
- Electronic publication date
- 05/05/2025
- Date published
- 02/2026
- Academic Unit
- Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984820566002771
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