Skip to main content
Journal cover image

Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report.

Publication ,  Journal Article
Osorno-Cruz, C; Piscopo, A; Raghuram, A; Sanchez, S; Samaniego, E; Hasan, D
Published in: Clin Neurol Neurosurg
December 2021

Edema coursing the optic apparatus has traditionally been associated with sellar and para-sellar tumors. However, postoperative aneurysmal volume expansion following endovascular treatment has been reported to induce cranial neuropathies, such as vision loss in rare instances. Here, we present a case report of worsening optic tract edema associated with bilateral visual acuity deficit following treatment of a large left paraophthalmic aneurysm with pipeline-assisted coiling. Rapid resolution of visual deficit was observed following administration of corticosteroids. A 42-year-old female with a 6-month history of worsening left eye vision and sentinel headache presented with left visual field cut and decreased left visual acuity. She was found to have a large paraophthalmic aneurysm which was treated with pipeline-assisted coiling. Within one week post-treatment, the patient presented to the emergency department with worsening right visual complaints. On magnetic resonance imaging, T2 hyperintensities coursing the right posterior optic nerve, optic chiasm, and bilateral optic tracts were noted. Angiography demonstrated an expanding neck remnant. The patient was treated with oral corticosteroids and repeat pipeline stenting. At four week follow up, she demonstrated significant improvement of symptoms and reduced T2 hyperintensities. With the advancement in endovascular technique for the treatment of large aneurysms, more patients are electing endovascular treatment over microsurgical clipping. Given the possibility of continued growth following endovascular treatment, patient counseling regarding risks and side effects is paramount.

Duke Scholars

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2021

Volume

211

Start / End Page

107029

Location

Netherlands

Related Subject Headings

  • Stents
  • Postoperative Complications
  • Optic Tract
  • Ophthalmic Artery
  • Neurology & Neurosurgery
  • Humans
  • Glucocorticoids
  • Female
  • Endovascular Procedures
  • Dexamethasone
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Osorno-Cruz, C., Piscopo, A., Raghuram, A., Sanchez, S., Samaniego, E., & Hasan, D. (2021). Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report. Clin Neurol Neurosurg, 211, 107029. https://doi.org/10.1016/j.clineuro.2021.107029
Osorno-Cruz, Carlos, Anthony Piscopo, Ashrita Raghuram, Sebastian Sanchez, Edgar Samaniego, and David Hasan. “Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report.Clin Neurol Neurosurg 211 (December 2021): 107029. https://doi.org/10.1016/j.clineuro.2021.107029.
Osorno-Cruz C, Piscopo A, Raghuram A, Sanchez S, Samaniego E, Hasan D. Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report. Clin Neurol Neurosurg. 2021 Dec;211:107029.
Osorno-Cruz, Carlos, et al. “Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report.Clin Neurol Neurosurg, vol. 211, Dec. 2021, p. 107029. Pubmed, doi:10.1016/j.clineuro.2021.107029.
Osorno-Cruz C, Piscopo A, Raghuram A, Sanchez S, Samaniego E, Hasan D. Reversible bilateral optic tract edema following pipeline-assisted coiling of a large ophthalmic aneurysm: A case report. Clin Neurol Neurosurg. 2021 Dec;211:107029.
Journal cover image

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

December 2021

Volume

211

Start / End Page

107029

Location

Netherlands

Related Subject Headings

  • Stents
  • Postoperative Complications
  • Optic Tract
  • Ophthalmic Artery
  • Neurology & Neurosurgery
  • Humans
  • Glucocorticoids
  • Female
  • Endovascular Procedures
  • Dexamethasone