title: Role of superior hypophyseal artery in visual function impairment after paraclinoid carotid artery aneurysm surgery.
abstract: OBJECTIVE
  Although a number of studies have assessed the surgical treatment of paraclinoid-segment carotid artery aneurysms and resulting visual complications, less attention has been given to the results with respect to the superior hypophyseal artery (SHA). The authors evaluated the relationship between the aneurysm, the SHA itself, and postoperative visual function in patients with ruptured and unruptured SHA aneurysms.
  
  
  METHODS
  From January 1991 through December 2013, 181 patients with 190 paraclinoid carotid artery aneurysms received treatment at Shinshu University Hospital and its affiliated hospitals. The authors retrospectively analyzed charts, operative records, operative videos, and neuroimaging findings for these patients with or without postoperative visual complications.
  
  
  RESULTS
  The authors identified 72 SHA aneurysms in 70 patients (mean age 58 years). Of 69 patients (1 patient died) evaluated, postoperative visual complications occurred in 9 (13.0%). Although the aneurysm size and SHA sacrifice did not lead to postoperative visual impairment, simultaneous treatment of bilateral aneurysms was a risk factor for postoperative visual complications.
  
  
  CONCLUSIONS
  Unilateral SHA impairment may be safe (i.e., it may not induce ischemia of the optic pathway) for many, but not all, patients with SHA aneurysm.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Neurosurgery, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kodama
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto; and.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010902:Pituitary Gland / Q000098:blood supply*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology
keywords: ICA = internal carotid artery; SHA = superior hypophyseal artery; VEP = visual evoked potential; aneurysm; internal carotid artery; superior hypophyseal artery; surgery; vascular disorders