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Journal of Korean Neurosurgical Society 2006;40(6): 455-458.
Blindness Caused by Wrapping of the ICA Aneurysm.
Jae Kwan Lim, Hyung Sik Hwang, Seung Myung Moon, Sun Kil Choi
Department of Neurosurgery, College of Medicine, Hallym University, Seoul, Korea. hyungsik99@yahoo.co.kr
The incidence of blindness after aneurysm surgery is very rare. We experienced a case of unilateral blindness after internal carotid artery(ICA) aneurysm wrapping. A 43-year-old male immediately developed ipsilateral ocular pain and visual loss in his left eye after the treatment of a lateral ICA aneurysm by wrapping with muscle pieces. He had also multiple aneurysms, which were multilobulated anterior communicating artery (A-com), middle cerebral artery(MCA) and posterior communicating artery (P-com) aneurysms. Coilings were done for a part of A-com artery aneurysm and P-com artery aneurysm on admission. The remaining A-com artery aneurysm was clipped and ICA aneurysm was wrapped with temporal muscle piece. A retrobulbar optic neuropathy might have resulted from either direct injury or damage to small dural vessels of the posterior optic nerve. Actually, the optico-carotid space was tight and the optic nerve was compressed by swollen muscle piece. Despite releasing of compression of the optic nerve on second day, his visual loss was irreversible.
Key Words: Blindness; Wrapping; ICA aneurysm
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