World Neurosurg
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Case Reports
Surgical decompression for optic neuropathy from carotid artery ectasia: case report with technical considerations.
Symptomatic compression of the optic nerve (ON) through its intracranial course or within the orbit may occur at several locations by abnormalities of adjacent soft tissue, bony, or vascular structures. Compressive optic neuropathy secondary to vascular ectasia is a rare phenomenon. ⋯ We present a patient with severe monocular visual loss and significant anatomic displacement of the ON by an ectatic internal carotid artery-ophthalmic artery complex with dramatic and rapid visual improvement after surgical decompression. Complete untethering of the nerve and total cessation of transmitted pulsatility may not be necessary for symptomatic improvement. Optic nerve contact or displacement by the ipsilateral carotid artery is common in asymptomatic patients, therefore ruling out other etiologies of monocular visual loss before surgical decompression is paramount.