Microvascular decompression of the optic chiasm. Case report.
Elongation of the anterior cerebral artery (ACA) and subsequent compression of the chiasm rarely have been reported as causes of a visual field deficit. Neither has microvascular decompression of the chiasm been described in this circumstance. The authors report on a case of progressive visual deficits caused by compression of the optic apparatus by a right elongated ACA as documented on MR imaging. Microvascular decompression was proposed as treatment. The right A(1) segment was larger than usual and tortuous, transmitting its pulsations into the chiasm. A piece of Teflon was inserted between the A(1) segment and the chiasm. Following surgery, the visual field deficit progressively improved. At 4 months after surgery, the patient's visual fields were normal. Therefore, an elongated ACA can compress the chiasm and result in a visual field deficit. In such circumstances when facing a progressive visual field deficit, microvascular decompression may improve vision.
Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal-Hôpital Notre-Dame, Montreal, Quebec, Canada.
Nancy
N
McLaughlin
Michel W
MW
Bojanowski
D020771:Anterior Cerebral Artery / Q000002:abnormalities / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm / Q000473:pathology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery; D014787:Vision Tests; D014792:Visual Acuity; D014794:Visual Fields