Junctional Chiasmatic Syndrome Due to Large Anterior Communicating Artery Aneurysm

Kesani, Maruthi; Pelluru, Pavan Kumar; Bhattacharjee, Suchanda; Alugolu, Rajesh; Purohit, A K

doi:10.4103/jnrp.jnrp_512_16

Cited by 2 publications

(1 citation statement)

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“…Although unruptured anterior communicating artery (Acom) aneurysms, especially those manifesting in a way that compresses the optic nerves, are rare (1-2%), large Acom aneurysms are frequently reported to compress the optic nerves. [1][2][3] Partially thrombosed large Acom aneurysms are reportedly difficult to treat by direct open surgery and endovascular treatment. Direct open surgery often requires thrombectomy, aneurysmal reconstruction, and bypass surgery.…”

Section: Introductionmentioning

confidence: 99%

Recovery of Visual Loss Following Internal Trapping of Anterior Cerebral Artery (A1 Segment) for Partially Thrombosed Large Anterior Communicating Artery Aneurysm: A Case Report

Orihara

Tone

Sato

et al. 2021

NMC Case Report Journal

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A 60-year-old woman, who experienced progressive right visual loss, was diagnosed with an unruptured large cerebral aneurysm. Magnetic resonance imaging (MRI) and angiography revealed a large partially thrombosed anterior communicating artery (Acom) aneurysm. The aneurysmal neck was located at the junction of the left A1–A2 segments, and the aneurysmal dome communicated with the right A1–A2 junction by the Acom. Endovascular treatment using the flow alteration technique was selected. Following an oral antiplatelet therapy for 9 days, balloon test occlusion (BTO) of the medial portion of the left A1 segment was performed under local anesthesia. After confirming the tolerance of the BTO, internal trapping of the medial portion of the left A1 segment by detachable coils was performed following intra-aneurysmal coil embolization. Oral antiplatelet treatment was continued for 19 days postoperatively. Within 3 months following the operation, her right visual acuity dramatically improved to the original level. Owing to aneurysmal recanalization and the disappearance of the thrombus, the second and third embolization was performed through the Acom route, 4 months and 3 years following the first embolization, respectively, and followed up for an additional 7 years by MRI; no deterioration of her visual acuity and no aneurysmal recanalization was observed. Thus, endosaccular embolization combined with flow alteration is considered a useful alternative treatment for large and partially thrombosed Acom aneurysms.

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Section: Introductionmentioning

confidence: 99%