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J Stroke

Title:		Anterior Optic Pathway Compression Due to Internal Carotid Artery Aneurysms: Neurosurgical Management and Outcomes
Author(s):		Park W; Park JC; Han K; Ahn JS; Kwun BD;
Address:		"Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical center, Seoul, Korea. Biostatistics Collaboration Unit, Gangnam Medical Research Center, Yonsei University College of Medicine, Seoul, Korea"
Journal Title:		J Stroke
Year:		2015
Volume:		20150930
Issue:		3
Page Number:		344 - 353
DOI:		10.5853/jos.2015.17.3.344
ISSN/ISBN:		2287-6391 (Print) 2287-6405 (Electronic) 2287-6391 (Linking)
Abstract:		"BACKGROUND AND PURPOSE: Compression of the anterior optic pathway results in visual deficits that can lead to the detection of unruptured aneurysms in the internal carotid artery (ICA). The general types of treatment modalities for aneurysms and visual deficits include surgery and endosaccular coiling. This study retrospectively analyzed and compared the resolution of visual deficits following surgery or endosaccular coiling. METHODS: We reviewed data on 33 patients with unruptured ICA aneurysms who presented with visual field deficits caused by mass effects over the anterior optic pathway. Statistical analyses were performed to identify the variables associated with the recovery of visual symptoms. RESULTS: Eighteen patients underwent aneurysm clipping, 2 underwent bypass surgery with endovascular trapping, and 2 underwent endovascular trapping without bypass surgery (group A). Ten patients received endosaccular coiling (group B). The visual outcomes included the following: in group A, 17 patients (73.9%) demonstrated improvement and 6 patients (26.1%) demonstrated no changes or worse outcomes; in group B, 2 patients (20.0%) demonstrated improvement and 8 patients (80.0%) demonstrated no changes or worse outcomes. Group A was associated with a higher rate of favorable outcome than group B (P = 0.007). According to the multivariate analysis, treatment without endosaccular coiling (group A) was the only variable significantly associated with improvement of visual outcome (P = 0.005; OR = 28.523; 95% CI = 2.683-303.171). CONCLUSIONS: Treatment modality was the only predictor of improvement in visual deficits. Treatment without endosaccular coiling resulted in visual improvement significantly more often in comparison with endosaccular coiling"
Keywords:		Aneurysm Coil Embolization Internal carotid artery Surgery Visual symptom;
Notes:		"PubMed-not-MEDLINEPark, Wonhyoung Park, Jung Cheol Han, Kyunghwa Ahn, Jae Sung Kwun, Byung Duk eng Korea (South) 2015/10/07 J Stroke. 2015 Sep; 17(3):344-53. doi: 10.5853/jos.2015.17.3.344. Epub 2015 Sep 30"