Journal article
Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report
Clinical neurology and neurosurgery, Vol.211, pp.107029-107029
12/01/2021
DOI: 10.1016/j.clineuro.2021.107029
PMID: 34794059
Abstract
Edema coursing the optic apparatus has traditionally been associated with sellar and para-sellar tumors. However, postoperative aneurysmal volume expansion following endovascular treatment has been reported to induce cranial neuropathies, such as vision loss in rare instances. Here, we present a case report of worsening optic tract edema associated with bilateral visual acuity deficit following treatment of a large left paraophthalmic aneurysm with pipeline-assisted coiling. Rapid resolution of visual deficit was observed following administration of corticosteroids. A 42-year-old female with a 6-month history of worsening left eye vision and sentinel headache presented with left visual field cut and decreased left visual acuity. She was found to have a large paraophthalmic aneurysm which was treated with pipeline-assisted coiling. Within one week post-treatment, the patient presented to the emergency department with worsening right visual complaints. On magnetic resonance imaging, T2 hyperintensities coursing the right posterior optic nerve, optic chiasm, and bilateral optic tracts were noted. Angiography demonstrated an expanding neck remnant. The patient was treated with oral corticosteroids and repeat pipeline stenting. At four week follow up, she demonstrated significant improvement of symptoms and reduced T2 hyperintensities. With the advancement in endovascular technique for the treatment of large aneurysms, more patients are electing endovascular treatment over microsurgical clipping. Given the possibility of continued growth following endovascular treatment, patient counseling regarding risks and side effects is paramount.
Details
- Title: Subtitle
- Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report
- Creators
- Carlos Osorno-Cruz - University of IowaAnthony Piscopo - University of IowaAshrita Raghuram - University of IowaSebastian Sanchez - University of IowaEdgar Samaniego - University of IowaDavid Hasan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.211, pp.107029-107029
- Publisher
- Elsevier
- DOI
- 10.1016/j.clineuro.2021.107029
- PMID
- 34794059
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Number of pages
- 4
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984418936602771
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