両側上下垂体動脈閉塞で視障害を生じたと考えられる２症例

Abstract

Superior hypophyseal arteries originate from the paraclinoid segment of the internal carotid artery. They distribute to the optic pathway and pituitary gland. It has not been reported whether occlusion of these arteries produces visual loss. We experienced 2 patients whose vision deteriorated after clipping surgery for bilateral paraclinoid aneurysms. Those aneurysms were found to arise at the junction with superior hypophyseal arteries. Those arteries were obliterated bilaterally together with the aneurysms. The patients suffered visual disturbance in both eyes temporarily in 1 patient and permanently in another. Bilateral superior hypophyseal arteries should not be obliterated simultaneously and visual evoked potential should be monitored even when a single superior hypophyseal artery needs to be sacrificed if its caliber is large.