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

Nowicki, Kamil W; Johnson, Stephen A; Goldschmidt, Ezequiel; Balzer, Jeffrey; Gross, Bradley A; Friedlander, Robert M · World Neurosurg · 2020

case_report · Level V

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Abstract

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. 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. 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.

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