Optic neuropathy as the complication after clipping of aneurysms of internal carotid artery, anterior cerebral and anterior communicating arteries
Objective: to evaluate the changes of visual function and to analyze the causes of visual impairment in patients suffered from paraclinoid aneurysms of internal carotid artery as well as from aneurysms of anterior cerebral and anterior communicating arteries after aneurysms clipping. Materials and methods: the risk of postoperative visual disturbances was estimated as high in 70 patients with paraclinoid aneurysms of internal carotid artery as well as with aneurysms of anterior cerebral and anterior communicating arteries. All these patients underwent comprehensive assessment of visual functions using standard examination methods before and after surgery. Results: early postoperative complications in form of acute optic neuropathy were observed in 7 patients (10%) with paraclinoid aneurysms, among them 4 patients had improvement of visual functions during the treatment in the early postoperative period, 2 patients had improvement of visual functions within 3-6 postoperative months, and 2 patients had no any improvement. There were no postoperative visual disturbances in patients with aneurysms of anterior cerebral and anterior communicating arteries Conclusion: satisfactory visual functions in the preoperative period in patients with paraclinoid aneurysms of internal carotid artery do not always mean the preservation of optic nerve. The patients suffered from ophthalmic aneurysms with upward dome position have the worst prognosis for visual functions preservation in postoperative period.