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Unruptured Ophthalmic Artery Aneurysm Presenting with Vision Loss 

Unruptured Ophthalmic Artery Aneurysm Presenting with Vision Loss
Chapter:
Unruptured Ophthalmic Artery Aneurysm Presenting with Vision Loss
Author(s):

Harry Van Loveren

, Zeguang Ren

, Pankaj Agarwalla

, and Siviero Agazzi

DOI:
10.1093/med/9780190887728.003.0007
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date: 12 April 2021

Abstract: Intracranial aneurysms pose a significant clinical challenge for cerebrovascular and endovascular neurosurgeons both in treatment decision-making and in the technical aspects. The most important question is whether the aneurysm has ruptured, thereby necessitating urgent treatment. In the unruptured ophthalmic artery aneurysm case with vision loss, the decision to treat rests on understanding the risk of hemorrhage, the success in addressing neurological deficits, and the morbidity of any potential treatment. Computed tomography angiography, conventional angiography, and magnetic resonance imaging are critical and complementary in the diagnosis and management of ophthalmic artery aneurysms, which have also been termed paraclinoid or junctional aneurysms. Due to technological advances, multiple treatment methods are possible, including surgical clipping, endovascular coiling, and flow diversion. Flow diversion is emerging as an effective, less invasive technique with good vision outcomes. This chapter discusses the data behind decision-making, reviews the surgical technique of flow diversion, and emphasizes important aspects of perioperative management.

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