神经栓塞治疗颅内动脉瘤后视野缺损的改善。病例报告。

Q4 Medicine Ceska a Slovenska Oftalmologie Pub Date : 2024-01-01 DOI:10.31348/2024/8
Nora Majtánová, Petr Kolář, Petra Krišková, Petra Kéri, Tibor Balazs, Dalibor Cholevík, Veronika Kurilová
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引用次数: 0

摘要

目的:颅内动脉瘤及其出血和血栓栓塞并发症是一种严重的疾病,对患者造成极大威胁。在发生破裂之前,它们大多没有症状。在两份病例报告中,我们对视力受损和头痛的年轻患者进行了观察,发现他们存在颅内动脉瘤:两例患者因视力受损和头痛来我科就诊。患者在本中心接受了全面的眼科检查,包括视野检查。根据检查结果,他们被转诊接受脑部成像检查,结果显示存在颅内动脉瘤。患者随后被送往介入神经放射学中心,在那里接受了植入血流分流器的无创血管内神经栓塞术。术后我们继续对患者进行监测,并记录检查结果,直至术后一年:得益于对这两名患者的快速检测、诊断和处理,我们避免了动脉瘤破裂这一危及生命的并发症的发生。在植入血流分流器的血管内手术后,我们观察到两名患者的视力和周边检查结果都有明显改善。如果在出现眼部症状一周内发现颅内动脉瘤并在三个月内进行治疗,我们的两名患者的视野缺损会在 6-12 个月内得到改善,其中一名患者的视野缺损几乎完全消失。
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Improvement of Visual Field Defects after Neuroembolization Treatment of Intracranial Aneurysms. Case Reports.

Purpose: Intracranial aneurysms and their hemorrhagic and thromboembolic complications represent a serious nosological unit that significantly endangers those afflicted. They are mostly asymptomatic until rupture occurs. In two case reports, we present our observations of young patients with impaired vision and headaches, in whom we found the presence of intracranial aneurysms.

Observations: Presentation of two case reports of patients who came to our department with impaired vision and headaches. The patients underwent a complete eye examination at our center, including a visual field examination. Based on the results of the examination, they were referred for  an imaging examination of the brain, which revealed the presence of intracranial aneurysms. The patients were subsequently sent to the interventional neuroradiology center, where they underwent a noninvasive endovascular neuroembolization procedure with flow diverter implantation. We continued to monitor the patients after the procedure and document the examination results up to 1 year after the procedure.

Conclusions and significance: Thanks to the fast detection, diagnosis, and management of both patients, we prevented the occurrence of aneurysm rupture, thus a life-threatening complication. After endovascular procedures with flow diverter implantation, we observed a significant improvement in visual acuity as well as perimetric findings in both patients. When intracranial aneurysms are found within a week of the onset of eye symptoms and treated within three months, defects in the visual fields improved in our two patients within 6-12 months, and in one of the two patients the defects almost completely disappeared.

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Ceska a Slovenska Oftalmologie
Ceska a Slovenska Oftalmologie Medicine-Ophthalmology
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