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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Visual symptoms caused by intracranial aneurysms: the influence of surgical and endovascular treatment on visual outcome – single center series and systemic review

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  • Patrick Schuss - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
  • Erdem Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
  • Volker Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
  • Hartmut Vatter - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1579

doi: 10.3205/10dgnc054, urn:nbn:de:0183-10dgnc0540

Published: September 16, 2010

© 2010 Schuss et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Our objective was to analyse the recovery of visual deficits caused by intracranial aneurysms after surgical clipping or endovascular treatment achieving decompression of the optic nerve or reduction of aneurysm pulsatility respectively.

Methods: Between June 1999 and December 2009, 20 consecutive patients with unruptured intracranial aneurysms causing visual dysfunction due to compression of the optic nerve were treated at our institution. Visual deficits were recorded on admission and on follow-up. MEDLINE was searched for published studies of aneurysm caused visual disturbance. Two reviewers independently extracted data.

Results: Of 20 patients treated in our institution, 12 underwent surgical clipping (60%) and 8 endovascular coiling (40%). After treatment, 9 of 12 surgically treated patients versus (vs.) 3 of 8 endovascularly treated patients showed an improvement of visual symptoms (75% vs. 38%).

Literature data, including the current series revealed a total of 181 patients. Surgical treatment was associated with a significantly higher rate of visual improvement (70% vs. 39%; p=0.0002, OR 3.6, CI 1.8–7.1) compared to endovascular treatment.

Conclusions: The present data indicates that visual impairment caused by intracranial aneurysms improves significantly more often in patients after surgical treatment compared to endovascular coiling, which might influence surgical decision making.