Visual loss after neurosurgical repair of paraclinoid aneurysms.
OBJECTIVE
To describe three cases of unexplained visual loss after technically successful clipping of paraclinoid aneurysms.


METHODS
Three case reports are presented.


RESULTS
Profound blindness occurred in all three patients. Only one patient had marked visual recovery. Two clinical patterns were observed. A fulminant orbital syndrome presumably from compromise of large draining veins of the orbit was observed in one patient. A retrobulbar optic neuropathy that might have resulted from either direct injury or damage to small dural vessels of the posterior optic nerve was observed in the other two patients.


CONCLUSIONS
There is a risk of postoperative blindness after clipping of paraclinoid aneurysms. The frequency of this complication may increase because attempts to repair these aneurysms are becoming more common. Patients with paraclinoid aneurysms should receive preoperative and postoperative neuro-ophthalmologic examinations.
Rizzo
J F
JF
Department of Ophthalmology, Harvard Medical School, Boston, USA.
D000328:Adult; D001766:Blindness / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000601:surgery; D009900:Optic Nerve / Q000098:blood supply; D011183:Postoperative Complications; D012160:Retina / Q000473:pathology; D014792:Visual Acuity; D014794:Visual Fields