Articles: ophthalmic-artery-surgery.
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Some types of carotid-ophthalmic artery aneurysms are still difficult to clip successfully because their exposure requires opening the cavernous sinus and/or retracting the optic nerve. It is useful to know the complications and to determine the type of aneurysm preoperatively for the management of carotid-ophthalmic artery aneurysms. ⋯ When direct operation is performed for a carotid-ophthalmic artery aneurysm, care must be taken to avoid optic nerve injury caused by the retraction and/or the heat of the drill.
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Journal of neurosurgery · May 1990
Aneurysms of the ophthalmic segment. A clinical and anatomical analysis.
The clinical, radiographic, and anatomical features in 80 patients with ophthalmic segment aneurysms were reviewed, and were categorized according to a presumed origin related to the ophthalmic (41 cases) or superior hypophyseal (39 cases) arteries. There was a marked female predominance (7:1) and high incidence of multiple aneurysms (45%) within this population. Clinical presentations included subarachnoid hemorrhage in 23 cases (29%) and visual deficits in 24 (30%); five patients exhibited both hemorrhage and visual loss. ⋯ The carotid artery was usually located lateral or superolateral relative to the aneurysm. These lesions could extend medially beneath the chiasm (suprasellar variant), producing a clinical and computerized tomography picture similar to a pituitary adenoma, or they could extend ventrally to burrow beneath the anterior clinoid process (paraclinoid variant). Preoperative categorization of these lesions according to their likely branch of origin provides excellent correlation with visual deficits and operative findings, and has allowed the author to clip 52 of 54 lesions, with very low operative or visual morbidity.
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Acta neurochirurgica · Jan 1985
Case ReportsMicrosurgical anatomy around the origin of the ophthalmic artery with reference to contralateral pterional surgical approach to the carotid-ophthalmic aneurysm.
The supraclinoid segments of the internal carotid artery (ICA) and their surrounding structures were examined under magnification in 25 adult cadavers. Attention was paid to anatomical variations and relationships concerning ipsilateral and contralateral pterional microsurgical approaches to these regions, especially to the origin of the ophthalmic artery. Eighty-four percent of the ophthalmic arteries arose from the supraclinoid segment of the ICA. ⋯ This study supports the usefulness of the contralateral pterional approach to the origin of the ophthalmic artery and the medial aspect of the supraclinoid segment of the ICA. This approach could be useful in certain cases of carotid-ophthalmic aneurysm. The authors' experience with the contralateral pterional approach to carotid-ophthalmic aneurysms is also described.