Visual Evoked Potentials and Intraoperative Awakening in Ophthalmic Artery Sacrifice During Aneurysm Clipping: 2 Cases and Literature Review

World Neurosurg. 2020 Jul:139:395-400. doi: 10.1016/j.wneu.2020.04.196. Epub 2020 May 4.

Abstract

Background: Complete aneurysm obliteration is the goal of aneurysm treatment. In selected cases, a neck remnant may be left to preserve a critical branch. Literature on ophthalmic artery sacrifice in the treatment of cerebral aneurysms and subsequent risk of vision loss is limited.

Case description: Herein, we describe 2 cases where the ophthalmic artery originated from the aneurysm dome, resulting in a situation where we either incompletely obliterate the aneurysm or sacrifice the ophthalmic artery in order to completely clip the lesion, risking visual function.

Conclusions: We report for the first time the use of visual evoked potential monitoring and intraoperative awakening to test visual function following intentional ophthalmic artery sacrifice to demonstrate gross vision preservation.

Keywords: Aneurysm; Ophthalmic artery; Preservation; Sacrifice; VEP; Vision.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Evoked Potentials, Visual / physiology*
  • Female
  • Humans
  • Intracranial Aneurysm / surgery*
  • Intraoperative Neurophysiological Monitoring / methods*
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Ophthalmic Artery / surgery*
  • Surgical Instruments