Aneurysms of the Intracranial Segment of the Ophthalmic Artery Trunk: Case Report and Systematic Literature Review

Simone Peschillo; Francesco Biraschi; Francesco Diana; Claudio Colonnese; Marco Marenco; Roberto Delfini

doi:10.1055/s-0037-1604268

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2018; 79(03): 257-261
DOI: 10.1055/s-0037-1604268

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Aneurysms of the Intracranial Segment of the Ophthalmic Artery Trunk: Case Report and Systematic Literature Review

Simone Peschillo

¹Department of Neurology and Psychiatry, Endovascular Neurosurgery, University of Rome “Sapienza,” Rome, Italy

,

Francesco Biraschi

²Department of Neurology and Psychiatry, Interventional Neuroradiology, Universita degli Studi di Roma La Sapienza Ringgold Standard Institution, Roma, Lazio, Italy

,

Francesco Diana

¹Department of Neurology and Psychiatry, Endovascular Neurosurgery, University of Rome “Sapienza,” Rome, Italy

,

Claudio Colonnese

¹Department of Neurology and Psychiatry, Endovascular Neurosurgery, University of Rome “Sapienza,” Rome, Italy

³Department of Neuroradiology, IRCCS INM Neuromed Pozzilli, Rome, Italy

,

Marco Marenco

⁴Department of Sense Organs, Ophthalmology, “Sapienza,” University of Rome, Rome, Italy

,

Roberto Delfini

¹Department of Neurology and Psychiatry, Endovascular Neurosurgery, University of Rome “Sapienza,” Rome, Italy

› Author Affiliations

Abstract

Aneurysms arising from the ophthalmic artery trunk (OAT) are very rare, particularly in the artery's intracranial course. The onset of a subarachnoid hemorrhage (SAH) from a ruptured OAT aneurysm in this segment is extremely rare. We present a case and discuss the anatomy, clinical significance, and therapeutic options for an aneurysm at this site. We also retrospectively analyzed the record of a patient with a ruptured aneurysm of the intracranial segment of the OAT and conducted a comprehensive and systematic review of the PubMed and Scopus databases for literature on this pathology. Only one case report of SAH from an aneurysm of the intracranial segment of the OAT was published in the literature. Only in our case was the intracranial OAT segment aneurysm discovered in the acute phase of SAH. Conventional angiography with three-dimensional acquisition may help detect aneurysms at this level. Detailed knowledge of the anatomy of the OAT is of paramount importance for both surgical and endovascular approaches. Surgical treatment is complex because of difficulties in accessing the orbital region and the risk of optic nerve and vascular injuries. Endovascular treatment, when feasible, could be a good alternative to reduce the risk of loss of vision related to surgical manipulation.

Keywords

systematic review - aneurysm - subarachnoid hemorrhage - ophthalmic artery

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References

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