title: Carotid-ophthalmic aneurysms-Our results and treatment strategy.
abstract: OBJECTIVE
  Ophthalmic aneurysms comprise 1.3-5% of all intracranial aneurysms and are the least likely to rupture. On the other hand, they can cause symptoms (visual dysfunction and eye movement palsy) in 18-35% of cases even when unruptured. In our article, we review all the cases of ophthalmic aneurysms treated in our department, discuss treatment methods, and compare our results with those reported in the literature.
  
  
  METHODS
  In the period 1998-2010, we operated on 37 patients and treated 21 endovascularly. Out of these surgically/endovascularly treated, there were 11/7 asymptomatic, 3/2 unruptured symptomatic, and 23/12 ruptured casess.
  
  
  RESULTS
  Surgically treated: Asymptomatic aneurysms were operated on with 9% (1 patient) mortality (due to delayed infection); 87% of patients with ruptured aneurysms improved, 9% remained unchanged, and 4% got worse. Visual dysfunction was restored in 66% of unruptured symptomatic cases (2 patients operated on within 1 month of the start of symptoms). Endovascularly treated. Asymptomatic aneurysms were coiled with 9% (1 patient) mortality and 9% (1 patient) morbidity. Patients with ruptured aneurysms improved in 50% of cases, 25% of patients did not change, 1 patient got worse (12.5%), and 1 patient died (12.5%). Only 1 of 3 coiled patients showed improved 3rd nerve palsy after coiling of an unruptured aneurysm.
  
  
  CONCLUSIONS
  The mortality and morbidity of aneurysms treated in our department, both unruptured and ruptured, were relatively low and comparable with the results presented in the literature. The number of unruptured aneurysms with visual dysfunction was not as high as reported in the literature, but our results correlate with the main conclusion of those studies: to treat those aneurysms surgically when possible and within three months from the start of symptoms.
authors.affiliation: Department of Neurosurgery, Masaryk Hospital , Usti nad Labem , Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Orlický
authors.forename: Martin
authors.initials: M
authors.lastname: Sameš
authors.forename: Aleš
authors.initials: A
authors.lastname: Hejčl
authors.forename: Petr
authors.initials: P
authors.lastname: Vachata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000601:surgery*
keywords: carotid-ophthalmic aneurysms; clipping; coiling; visual dysfunction