눈운동장애 없이 시력 저하를 보인 해면정맥동 내경동맥류 1예

• 영문명: A Case of Intracavernous Carotid Aneurysm Presenting with Visual Loss with No Oculomotor Disturbance
• 발행기관: 대한안과학회
• 저자명: 김승훈 김선웅 김범태 장지호,Seung Hoon Kim, MD, Sun Woong Kim, MD, Bum-Tae Kim, MD, Jee Ho Chang, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume53,number3, 486~491쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2012.03.15

영문 초록

Purpose: Oculomotor disturbance is the common manifestation of intracavernous carotid aneurysm cases. Intracavernous carotid aneurysms causing compressive optic neuropathy with no oculomotor disturbance are relatively rare due to their anatomical characteristics. We experienced a case of intracavernous carotid aneurysm which resulted in a shifted supraclinoid segment of the internal carotid artery, presenting with visual loss and visual field defect with no oculomotor disturbance. Case summary: A 40-year-old woman presented with loss of vision in the right eye. A relative afferent pupillary defect was observed in this eye. Visual field test showed quadranopsia in the right eye. Magnetic resonance imaging revealed that the intracavernous carotid aneurysm had shifted the supraclinoid segment of the internal carotid artery to the superomedial position. The right optic nerve was directly molded by the shifted supraclinoid segment of the internal carotid artery at the point of the bifurcation between the anterior cerebral artery and the middle cerebral artery. A Guglielmi detachable coil (GDC) embolization was performed successfully with no operational complications. Six months after coiling, best corrected visual acuity of the right eye was 1.0, and the visual field defect had recovered in all except the superior temporal field. Conclusions: Oculomotor disturbance is frequently associated with intracavernous carotid aneurysms. Nevertheless, optic neuropathy without oculomotor disturbance may be the only sign in patients with an intracavernous carotid aneurysm that causes shifting of the supraclinoid segment of the internal carotid artery. J Korean Ophthalmol Soc 2012;53(3):486-491

키워드

Cavernous sinus, Internal carotid artery aneurysm, Intracavernous carotid aneurysm, Optic neuropathy, Visual dysfunction