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Aneurysms and subarachnoid hemorrhage.

V Biousse1, N J Newman

  • 1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.

Neurosurgery Clinics of North America
|October 26, 1999
PubMed
Summary
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Unruptured brain aneurysms often cause eye and vision problems by compressing nerves. Early detection and treatment of these intracranial aneurysms can prevent serious bleeding and vision loss.

Area of Science:

  • Neurology
  • Ophthalmology
  • Neurosurgery

Background:

  • Unruptured intracranial aneurysms frequently present with neuro-ophthalmologic signs, often due to compression of the third cranial nerve.
  • Compression of cranial nerves within the cavernous sinus or anterior visual pathways by aneurysms can lead to ocular motor nerve palsies and visual loss.
  • Ocular symptoms are critical presenting manifestations of intracranial aneurysms, highlighting the importance of early recognition.

Purpose of the Study:

  • To emphasize the significance of ocular symptoms in the presentation of unruptured intracranial aneurysms.
  • To underscore the role of early diagnosis and treatment in preventing catastrophic hemorrhage and visual morbidity.
  • To discuss the impact of recent advancements in neuroimaging and endovascular therapies on managing these conditions.

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Main Methods:

  • Review of clinical presentations of unruptured intracranial aneurysms with neuro-ophthalmologic manifestations.
  • Analysis of the mechanisms of cranial nerve and visual pathway compression by aneurysms.
  • Discussion of diagnostic modalities and therapeutic interventions, including noninvasive neuroimaging and endovascular treatments.

Main Results:

  • Aneurysms at the internal carotid-posterior communicating artery junction commonly compress the third nerve.
  • Cavernous sinus and anterior visual pathway compression by internal carotid artery aneurysms can cause ocular motor deficits and visual impairment.
  • Prompt identification of aneurysms before rupture is crucial for preventing severe neurological and visual complications.

Conclusions:

  • Ocular symptoms are vital indicators for the early detection of unruptured intracranial aneurysms.
  • Timely diagnosis and intervention are essential to avert devastating hemorrhages and mitigate visual morbidity.
  • Advances in neuroimaging and endovascular therapies offer improved prospects for managing intracranial aneurysms and their associated visual complications.