title: Microvascular Decompression of the Optic Nerve for Paroxysmal Phosphenes and Visual Field Deficit.
abstract: BACKGROUND
  Microvascular decompression surgery is standard neurosurgical practice for treating trigeminal neuralgia and hemifacial spasm. Most other cranial nerves have been decompressed for paroxysmal intermittent hyperactivity of the affected cranial nerve or in very long-standing compressions to treat cranial nerve hypofunctioning.
  
  
  METHODS
  We describe a case of intermittent paroxysmal unilateral phosphenes (i.e., light flashes) associated with worsening visual field defects. Magnetic resonance imaging showed a sandwiched optic nerve/chiasm between an inferior compression of the internal carotid artery and a superior compression of the anterior communicating artery. The patient was successfully treated by microvascular decompression and anterior clinoidectomy plus optic canal unroofing.
  
  
  CONCLUSIONS
  This case report adds to the few previous case reports combining 2 previously described techniques (i.e., microvascular decompression and anterior clinoidectomy plus optic canal unroofing).
authors.affiliation: Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: dirk.deridder@otago.ac.nz.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.affiliation: Department of Ophthalmology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Sime
authors.affiliation: Department of Internal Medicine, Section of Neurophysiology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Taylor
authors.affiliation: Department of Neurosurgery, University Hospital Antwerp, Belgium.
authors.forename: Tomas
authors.initials: T
authors.lastname: Menovsky
authors.affiliation: Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA.
authors.forename: Sven
authors.initials: S
authors.lastname: Vanneste
mesh_terms: D000368:Aged; D004948:Esotropia / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D009408:Nerve Compression Syndromes / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D009900:Optic Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010719:Phosphenes; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology*; D014794:Visual Fields
keywords: Microvascular decompression; Optic nerve; Paroxysmal phosphenes; Visual field deficit