[Ophthalmic artery aneurysms]. / Aneurismas de la región de la arteria oftálmica.

INTRODUCTION: Ophthalmic artery aneurysms are infrequent lesions and they have very specific particularities. OBJECTIVE: to present the anatomoclinical and surgical characteristic of our patients with ophthalmic aneurysms and to analyze our surgical results. PATIENT AND METHODS: 604 patients with intracranial aneurysms were operated on between January 1982 and December 2004. There were 50 patients with ophthalmic artery aneurysms. Average age was 52 years, 80% were women, 60% harbored multiple aneurysms and 20% were giant lesions. 12% had bilateral ophthalmic aneurysms. 20% of ophthalmic aneurysms were incidental. 50% had ophthalmological manifestations; however, this presentation occurred in 100% of the patients with large and giant aneurysms. Initially, 12% of ophthalmologic disorders were missed. We utilized unilateral or bilateral pterional approach associated to others in multiple aneurysms. We performed retrograde decompression- suction technique modified for large and giant aneurysms. RESULTS. Thirty patients (60%) obtained a complete recovery, fourteen patients (28%) an incomplete recovery and two were seriously disabled. There were not patients in vegetative state. There were four deaths (8%). 50% of postoperatory deficits disappeared and 64% of ophthalmologic disorders improved three months later. CONCLUSION: Microsurgical method allowed to treat unique, multiple, bilateral, large and giant ophthalmic aneurysms with good recovery of neurological and visual deficits.

Aneurismas de la región de la arteria oftálmica / Ophthalmic artery aneurysms

Introducción. Los aneurismas de la arteria oftálmica son lesiones poco frecuentes y con particularidades específicas. Objetivo. Presentar las características anatomoclínicas, quirúrgicas y los resultados del tratamiento microquirúrgico de nuestros pacientes con aneurismas de esta región. Pacientes y métodos. 604 pacientes con aneurismas intracraneales fueron llevados al quirófano entre enero de 1982 y diciembre del 2004. Hubo 50 pacientes con aneurismas de la región de la arteria oftálmica. El promedio de edad fue de 52 años, el 80 porciento fueron mujeres, el 60 porciento presentaban aneurismas múltiples y un 20 porciento gigantes. El 12 porciento poseían lesiones aneurismáticas bilaterales. El 20 porciento de los aneurismas fueron incidentales. El 50 porciento tenían manifestaciones oftalmológicas y la frecuencia se elevó al 100 porciento en los aneurismas grandes y gigantes. El 16 porciento de los trastornos visuales fueron ignorados o confundidos inicialmente. En aneurismas múltiples empleamos la ruta pterional uni o bilateral asociada a otros abordajes. En los aneurismas oftálmicos grandes o gigantes utilizamos la técnica de descompresión-succión retrógrada modificada. Resultados. Treinta pacientes (60 porciento) obtuvieron una recuperación completa, catorce pacientes (28 porciento) una recuperación incompleta y dos incapacidad grave. No hubo pacientes en estado vegetativo. Hubo cuatro fallecidos (8 porciento). El 50 porciento de los déficit postoperatorios desaparecieron y el 64 porciento de los trastornos visuales mejoraron a los tres meses. Conclusión. El método microquirúrgico permitió tratar aneurismas de la región de la arteria oftálmica únicos, múltiples, bilaterales, grandes y gigantes con buena recuperación de los déficit neurológicos y de los trastornos visuales(AU)

Introduction. Ophthalmic artery aneurysms are infrequent lesions and they have very specific particularities. Objective. to present the anatomoclinical and surgical characteristic of our patients with ophthalmic aneurysms and to analyze our surgical results. Patient and methods. 604 patients with intracranial aneurysms were operated on between January 1982 and December 2004. There were 50 patients with ophthalmic artery aneurysms. Average age was 52 years, 80 percent were women, 60 percent harbored multiple aneurysms and 20 percent were giant lesions. 12 percent had bilateral ophthalmic aneurysms. 20 percent of ophthalmic aneurysms were incidental. 50 percent had ophthalmological manifestations; howewer, this presentation occurred in 100 percent of the patients withlarge and giant aneurysms. Initially, 12 percent of ophthalmologic disorders were missed. We utilized unilateral or bilateral pterional approach associated to others in multiple aneurysms. We performed retrograde decompression-suction technique modified for large and giantaneurysms. Results. Thirty patients (60 percent) obtained a complete recovery, fourteen patients (28 percent) an incomplete recovery and two were seriously disabled. There were not patients in vegetative state. There were four deaths (8 ). 50 percent of postoperatory deficits disappeared and 64 percent of ophthalmologic disorders improved three months later. Conclusion. Microsurgical method allowed to treat unique, multiple, bilateral, large and giant ophthalmicaneurysms with good recovery of neurological and visual deficits(AU)