Johnson Jeremiah Nicholas, Elhammady Mohamed, Post Judith, Pasol Joshua, Ebersole Koji, Aziz-Sultan Mohammad Ali
Department of Neurosurgery, University of Miami, Miami, Florida, USA.
BMJ Case Rep. 2013 Dec 17;2013:bcr2013010968. doi: 10.1136/bcr-2013-010968.
We report a case of visual deterioration after Onyx HD 500 embolization of a left 7 mm superior hypophyseal artery (SHA) aneurysm. After the procedure, the patient experienced a right incongruous homonymous hemianopia, and MRI showed an infarct of the ipsilateral optic chiasm/tract but no evidence of aneurysm mass effect or embolic cortical infarcts. The optic pathway ischemia is believed to be secondary to Onyx penetration and occlusion of an SHA branch near the aneurysm neck. Caution is advised when using liquid embolic agents to treat SHA aneurysms as SHA occlusion may lead to visual deficits.
我们报告了一例在使用Onyx HD 500栓塞左侧7mm垂体上动脉（SHA）动脉瘤后出现视力恶化的病例。术后，患者出现右侧不一致性同向性偏盲，MRI显示同侧视交叉/视束梗死，但未发现动脉瘤占位效应或栓塞性皮质梗死的证据。视神经通路缺血被认为是由于Onyx渗透并阻塞了动脉瘤颈部附近的SHA分支所致。在使用液体栓塞剂治疗SHA动脉瘤时应谨慎，因为SHA闭塞可能导致视力缺陷。
