Intraorbital aneurysm of the ophthalmic artery: a rare cause of apex orbitae compression syndrome.
OBJECTIVE
The purpose of this study was to report the case of a patient with a saccular, intraorbital aneurysm of the ophthalmic artery and to analyze the correlation between clinical symptoms and aneurysm localization with regard to the literature.


METHODS
We correlated the patient's clinical findings with anatomical substrates on magnetic resonance imaging and angiographic studies.


RESULTS
A 64-year-old woman presented with a rapidly progressive loss of visual acuity in her right eye, temporo-basal visual field defects, a temporal pallor of the optic disc and third and sixth nerve palsies. This apex orbitae compression syndrome was due to an aneurysm of the proximal intraorbital segment of the ophthalmic artery at a position inferolateral to the optic nerve, inferior to the third and medial to the sixth cranial nerve.


CONCLUSIONS
The symptoms caused by an aneurysm of the ophthalmic artery depend on its localization and spatial relationship to neural structures. While aneurysms of the intracranial and distal intraorbital segments may remain asymptomatic, those arising from the intracanalicular segment become clinically apparent with optic nerve conduction disorders. Aneurysms in the proximal intraorbital segment additionally provoke oculomotor disturbances due to compression of the third and sixth cranial nerves.
Ernemann
Ulrike
U
Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Germany. ulrike.ernemann@med.uni-tuebingen.de
Freudenstein
Dirk
D
Pitz
Susanne
S
Naegele
Thomas
T
D020434:Abducens Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000783:Aneurysm / Q000150:complications*; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D009880:Ophthalmic Artery / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D009915:Orbit / Q000098:blood supply*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000601:surgery