Giant aneurysm arising from the anterior cerebral artery and causing an isolated homonymous hemianopsia

A case of a giant aneurysm arising from the anterior cerebral artery and producing a left homonymous hemianopsia is presented. The aneurysm caused lateral compression of the posterior part of the optic chiasm. After preoperative dynamic assessment of the circle of Willis by angiography and by electroencephalographic recording during carotid artery compression, the aneurysm was trapped with microclips on the anterior cerebral artery proximal and distal to it. Visual field examination 6 months postoperatively showed complete visual field recovery. This is the first case of homonymous hemianopsia caused by an angiographically proven giant aneurysm of the ACA.