No shinkei geka. Neurological surgery
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A rare case of ruptured carotid-ophthalmic aneurysm splitting the optic nerve was reported. A 52-year-old man presented with a sudden severe headache and bilateral visual deterioration. His right visual acuity was hand motion and the left was 2.0. ⋯ Six months after the operation, the right visual acuity had improved to 0.08 and the visual field revealed nasal hemianopsia. The left visual acuity was unchanged while the visual field had improved to upper temporal quadrant hemianopsia. Various attempts to preserve the visual function were discussed.
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Case Reports
[Case of bilateral common carotid artery dissections due to localized dissection of the aortic arch].
We report a case of a 56-year-old man who had a localized dissection of the aortic arch presenting with left conjugate deviation, right homonymous hemianopsia, and right hemiparesis. Diffusion-weighted MRI revealed multiple fresh cerebral infarctions of the left cerebral hemisphere and the bilateral cerebellar hemispheres. The patient did not complain of chest pain, but thoracic computed tomography (CT) and three-dimensional CT angiography showed a localized dissection of the aortic arch at the bases of the brachiocephalic artery and left common carotid artery (CCA). ⋯ Neurological signs and symptoms gradually improved during his admission. The pseudolumen had yet to close and there has been no change in size and shape of the dissected aneurysm for about one year. It is necessary to carefully follow up the case and to keep in mind cerebral infarctions caused by aortic dissection.