J Korean Ophthalmol Soc > Volume 58(11); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(11):1276-1281.
DOI: https://doi.org/10.3341/jkos.2017.58.11.1276    Published online November 15, 2017.
The Neuro-ophthalmic Presentation of Intracranial Aneurysms.
Han Gyul Yoon, Dae Hyun Kim
Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea. eyelovehyun@hanmail.net
두개강내 동맥류 환자의 신경안과적 분석
조선대학교 의학전문대학원 안과학교실
Correspondence:  Dae Hyun Kim,
Email: eyelovehyun@hanmail.net
Received: 20 July 2017   • Revised: 1 September 2017   • Accepted: 16 October 2017
To investigate the neuro-ophthalmic diagnosis and clinical manifestations of intracranial aneurysm. METHODS: A retrospective survey of 33 patients who were diagnosed with intracranial aneurysm and underwent neuro-ophthalmic examination from April 2008 to December 2016. Frequency of the first diagnosis of intracranial aneurysm in ophthalmology, neuro-ophthalmic diagnosis, location of intracranial aneurysm, examination of intracranial aneurysm rupture, and neurologic prognosis of Terson's syndrome patients were analyzed by image examination, neurosurgery, and ophthalmology chart review. RESULTS: Of the 33 patients, most patients (n = 31, 94%) were diagnosed with intracranial aneurysm at the neurosurgical department and only 2 patients were diagnosed initially at the ophthalmology department. Causes and association were: Terson's syndrome (n = 10, 30%), third cranial nerve palsy (n = 10, 30%), internclear ophthalmoplegia (n = 4, 12%), visual field defect (n = 3, 9%), optic atrophy (n = 3, 9%), sixth cranial nerve palsy (n = 2, 6%), and nystagmus (n = 1, 3%). The location of intracranial aneurysms were: anterior communicating artery (n = 13, 39%), medial communicating artery (n = 12, 36%), and posterior communicating artery (n = 5, 15%). Ten of 33 patients had Terson's syndrome, and 6 patients (60%) with Terson's syndrome had apermanent neurological disorder such as agnosia, gait disorder and conduct disorder. CONCLUSIONS: Third cranial nerve palsy was the most common neuro-ophthalmic disease in patients presenting with intracranial aneurysm. The neuro-ophthalmic prognoses for those diseases were relatively good, but, if Terson's syndrome was present, neurological disorders (agnosia, gait disorder, conduct disorder) were more likely to remain after treatment.
Key Words: Intracranial aneurysm;Terson's syndrome;Third cranial nerve palsy;Neuro-ophthalmology

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