Ruptured aneurysm of the ophthalmic artery trunk demonstrated by three-dimensional rotational angiography: case report.
OBJECTIVE
Aneurysms arising from the ophthalmic artery are extremely rare, compared with carotid-ophthalmic aneurysms arising from the wall of the internal carotid artery. We present a very unusual type of aneurysm arising from the ophthalmic artery itself.


METHODS
A 54-year-old man presented with a sudden onset of headache and was transferred to a local hospital. Computed tomography demonstrated subarachnoid hemorrhage around the left anterior clinoid process, but digital subtraction angiography failed to localize the source of the hemorrhage. The patient was referred to our hospital for further evaluation and treatment. Conventional cerebral angiography did not reveal the source of the hemorrhage, but three-dimensional rotational angiography clearly demonstrated an aneurysm arising from the ophthalmic artery trunk, apart from the internal carotid artery.


METHODS
The patient underwent microsurgical clipping of the aneurysm via a left pterional craniotomy. The aneurysm originated from the bifurcation of the ophthalmic artery and a perforating artery to the optic nerve. The aneurysm was successfully obliterated, and the postoperative course was uneventful.


CONCLUSIONS
This report is the first to describe a case of a ruptured aneurysm arising from the ophthalmic artery trunk. We discuss the clinical significance of an aneurysm at this site, as well as the role of three-dimensional rotational angiography in determining the source of subarachnoid hemorrhage.
Yanaka
Kiyoyuki
K
Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan. kyanaka@md.tsukuba.ac.jp
Matsumaru
Yuji
Y
Kamezaki
Takao
T
Nose
Tadao
T
D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000601:surgery; D000792:Angiography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D012399:Rotation; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed