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Case report
Optic pathway infarct after Onyx HD 500 aneurysm embolization: visual pathway ischemia from superior hypophyseal artery occlusion
  1. Jeremiah Nicholas Johnson1,
  2. Mohamed Elhammady2,
  3. Judith Post3,
  4. Joshua Pasol4,
  5. Koji Ebersole1,
  6. Mohammad Ali Aziz-Sultan2
  1. 1Department of Neurosurgery, University of Miami, Miami, Florida, USA
  2. 2Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
  3. 3Department of Neuroradiology, University of Miami, Miami, Florida, USA
  4. 4Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
  1. Correspondence to Dr M Ali Aziz-Sultan, Department of Neurosurgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace (D4-6), Miami, FL 33136, USA; brainsurg{at}gmail.com

Abstract

We report a case of visual deterioration after Onyx HD 500 embolization of a left 7 mm superior hypophyseal artery (SHA) aneurysm. After the procedure, the patient experienced a right incongruous homonymous hemianopia, and MRI showed an infarct of the ipsilateral optic chiasm/tract but no evidence of aneurysm mass effect or embolic cortical infarcts. The optic pathway ischemia is believed to be secondary to Onyx penetration and occlusion of an SHA branch near the aneurysm neck. Caution is advised when using liquid embolic agents to treat SHA aneurysms as SHA occlusion may lead to visual deficits.

  • Aneurysm
  • Liquid Embolic Material
  • Stroke
  • Angiography
  • MRI

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