Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report
Extracranial-intracranial (EC-IC) high-flow bypass with internal carotid artery (ICA) ligation at the neck is an important treatment option for giant cavernous ICA dissecting aneurysm. Such treatment may be associated with many complications. We report a case that developed postoperative mono-ocular...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-09-01
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| Series: | Indian Journal of Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1697729 |
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| author | Forhad H. Chowdhury Sheikh Mohammod Ekramullah Mohammod Ibrahim Khalil Mohammod Shamsul Arifin |
| author_facet | Forhad H. Chowdhury Sheikh Mohammod Ekramullah Mohammod Ibrahim Khalil Mohammod Shamsul Arifin |
| author_sort | Forhad H. Chowdhury |
| collection | DOAJ |
| description | Extracranial-intracranial (EC-IC) high-flow bypass with internal carotid artery (ICA) ligation at the neck is an important treatment option for giant cavernous ICA dissecting aneurysm. Such treatment may be associated with many complications. We report a case that developed postoperative mono-ocular blindness. So far to our knowledge such complication has not been reported in the literature. A 14-year-old girl presented with recent headache, eye ache, occasional double vision, and occasional right-sided visual impairment. Neurologic examination revealed no abnormality. Computed tomographic (CT) scan of the head showed a large, right parasellar, and mostly hyperdense space-occupying lesion. CT angiogram of the brain showed giant dissecting aneurysm of right-sided cavernous segment ICA. A right-sided external carotid artery–radial artery graft–middle cerebral artery (ECA-RAG-MCA [M2]) high-flow bypass was done with ligation of the right ICA in the neck. Postoperatively, the patient developed complete, mono-ocular, and permanent blindness on right side. Mono-ocular blindness is a serious complication from ophthalmic/central retinal artery thrombosis in high-flow EC-IC bypass with ICA ligation. Strategy is required to find and to set for its prevention. |
| format | Article |
| id | doaj-art-8d201d9dbd3b4b50a35b2bf4931d9a07 |
| institution | DOAJ |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2019-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-8d201d9dbd3b4b50a35b2bf4931d9a072025-08-20T03:07:01ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672019-09-01080320721010.1055/s-0039-1697729Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case ReportForhad H. Chowdhury0Sheikh Mohammod Ekramullah1Mohammod Ibrahim Khalil2Mohammod Shamsul Arifin3Department of Neurosurgery, National Institute of Neurosciences and Hospital, Shere-e-bangla Nagar, Dhaka, BangladeshDepartment of Neurosurgery, National Institute of Neurosciences and Hospital, Shere-e-bangla Nagar, Dhaka, BangladeshDepartment of Neurosurgery, National Institute of Neurosciences and Hospital, Shere-e-bangla Nagar, Dhaka, BangladeshDepartment of Neurosurgery, Bangabandhu Sheikh Muzib Medical University, Dhaka, BangladeshExtracranial-intracranial (EC-IC) high-flow bypass with internal carotid artery (ICA) ligation at the neck is an important treatment option for giant cavernous ICA dissecting aneurysm. Such treatment may be associated with many complications. We report a case that developed postoperative mono-ocular blindness. So far to our knowledge such complication has not been reported in the literature. A 14-year-old girl presented with recent headache, eye ache, occasional double vision, and occasional right-sided visual impairment. Neurologic examination revealed no abnormality. Computed tomographic (CT) scan of the head showed a large, right parasellar, and mostly hyperdense space-occupying lesion. CT angiogram of the brain showed giant dissecting aneurysm of right-sided cavernous segment ICA. A right-sided external carotid artery–radial artery graft–middle cerebral artery (ECA-RAG-MCA [M2]) high-flow bypass was done with ligation of the right ICA in the neck. Postoperatively, the patient developed complete, mono-ocular, and permanent blindness on right side. Mono-ocular blindness is a serious complication from ophthalmic/central retinal artery thrombosis in high-flow EC-IC bypass with ICA ligation. Strategy is required to find and to set for its prevention.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1697729extracranial-intracranial high-flow bypassgiant cavernous internal carotid artery dissecting aneurysmradial artery graftmono-ocular blindness |
| spellingShingle | Forhad H. Chowdhury Sheikh Mohammod Ekramullah Mohammod Ibrahim Khalil Mohammod Shamsul Arifin Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report Indian Journal of Neurosurgery extracranial-intracranial high-flow bypass giant cavernous internal carotid artery dissecting aneurysm radial artery graft mono-ocular blindness |
| title | Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report |
| title_full | Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report |
| title_fullStr | Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report |
| title_full_unstemmed | Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report |
| title_short | Extracranial-Intracranial High-Flow Bypass with Internal Carotid Artery Ligation at Neck for Giant Cavernous Internal Carotid Artery Dissecting Aneurysm in a Teen Girl with Postoperative Unusual Complication of Mono-ocular Blindness: A Case Report |
| title_sort | extracranial intracranial high flow bypass with internal carotid artery ligation at neck for giant cavernous internal carotid artery dissecting aneurysm in a teen girl with postoperative unusual complication of mono ocular blindness a case report |
| topic | extracranial-intracranial high-flow bypass giant cavernous internal carotid artery dissecting aneurysm radial artery graft mono-ocular blindness |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1697729 |
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