Optic pathway infarct after Onyx HD 500 aneurysm embolization: Visual pathway ischemia from superior hypophyseal artery occlusion

Jeremiah Nicholas Johnson, Mohamed Elhammady, Judith Post, Joshua Pasol, Koji Ebersole, Mohammad Ali Aziz-Sultan

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Abstract

We report a case of visual deterioration after Onyx HD 500 embolization of a left 7 mm superior hypophyseal artery (SHA) aneurysm. After the procedure, the patient experienced a right incongruous homonymous hemianopia, and MRI showed an infarct of the ipsilateral optic chiasm/tract but no evidence of aneurysm mass effect or embolic cortical infarcts. The optic pathway ischemia is believed to be secondary to Onyx penetration and occlusion of an SHA branch near the aneurysm neck. Caution is advised when using liquid embolic agents to treat SHA aneurysms as SHA occlusion may lead to visual deficits.

Original languageEnglish (US)
JournalBMJ case reports
DOIs
StatePublished - Dec 17 2013

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ASJC Scopus subject areas

  • Medicine(all)

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