A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia.
10.3340/jkns.2015.58.3.291
- Author:
Won Bae SEUNG
1
;
Dae Yong KIM
;
Yong Seok PARK
Author Information
1. Department of Neurosurgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. ysparkns@kosinmed.or.kr
- Publication Type:Case Report
- Keywords:
Anterior communicating artery aneurysm;
Bitemporal hemianopsia;
Optic chiasm;
Subarachnoid hemorrhage;
Visual defect
- MeSH:
Adult;
Aneurysm;
Angiography;
Arteries;
Brain;
Carotid Artery, Internal;
Catheters;
Female;
Fingers;
Headache;
Hemianopsia*;
Humans;
Intracranial Aneurysm*;
Optic Chiasm;
Optic Nerve;
Pituitary Apoplexy;
Rupture;
Subarachnoid Hemorrhage;
Vision Disorders;
Visual Field Tests;
Visual Fields
- From:Journal of Korean Neurosurgical Society
2015;58(3):291-293
- CountryRepublic of Korea
- Language:English
-
Abstract:
Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an 18x8 mm dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy.
