Abstract
The majority of internal carotid aneurysm neuro-ophthalmologic disturbances are eyeball pain, complex ophthalmoplegia, pulsatile proptosis with conjunctival congestion and venous stasis retinopathy. Acute or chronic visual loss and visual field defect, clinical neuro-ophthalmological findings, resembling parasellar tumors or retrobulbar optic neuritis, are less usual in patients with aneurysms. Two cases of cerebral aneurysms with unusual neuro-ophthalmologic disturbances are presented. Case 1: Report of a 51-year-old female with left eye vision loss and inferonasal quadratanopia - a diagnosis of retrobulbar neuritis prior our neuro-ophthalmologic consultation was made. Computed tomography angiography showed right carotid artery aneurysm. Surgical treatment post cerebral angiography was suggested. Case 2: Report of a 56-year-old male with acromegaly and chiasmal neuro-ophthalmologic syndromes was described: left monocular vision loss, proptosis with third nerve palsy, dilated pupil and binasal hemianopia. MR angiography showed bilateral internal carotid artery aneurysm. No surgical treatment was performed, but endocrinological treatment was necessary. Two cases of internal carotid aneurysms were presented with unusual neuro- ophthalmologic disturbances, mimicking an optic neuritis and parasellar tumor. In conclusion the accurate differential diagnosis requires the correct neuroimaging - MRI and digital angiography, and the cooperation between the neuro-ophthalmologist, the interventional neuro-radiologist and the neurosurgeron.
Published Version
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