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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2023; 84(01): e6-e10
DOI: 10.1055/a-2008-4161
Case Report

Neurofibromatosis Type 1 with Giant Thrombotic Aneurysm of the Internal Carotid Artery Presenting with Rapid Progression of Visual Disturbance: A Case Report and Literature Review

Masato Kobayashi 
1   Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
,
Naoki Otani
1   Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
,
Ryuta Kajimoto
1   Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
,
Takamichi Katsuhara
1   Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
,
Atsuo Yoshino
1   Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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Abstract

Background Patients with neurofibromatosis type 1 (NF1) have various vascular diseases due to the vascular fragility, but no reports of case of giant thrombotic aneurysm was found. We treated a rare case of giant thrombotic aneurysm of the internal carotid artery (ICA) in a patient with NF1.

Case Presentation A 60-year-old man had suffered deteriorating visual loss and homonymous hemianopia. Contrast-enhanced computed tomography showed a giant thrombosed aneurysm on the anterior wall of the ICA located in the optic chiasma. We planned and completed the external carotid artery-middle cerebral artery high-flow bypass using radial artery graft. The visual fields test was performed 14 days after surgery. Homonymous hemianopia persisted but no exacerbation of visual field impairment was observed. No complications were found at 14 days after surgery and the postoperative course was uneventful.

Conclusion We consider that external carotid artery-middle cerebral artery bypass surgery using radial artery grafts is a safe and effective treatment method for giant thrombotic aneurysm associated with NF1.

Keywords

neurofibromatosis type 1 - thrombotic aneurysm - homonymous hemianopis - visual disturbance

Ethics Approval and Consent to Participate

None.


Consent for Publication

The patient has consented to submission of this case report for journal publication, and we have obtained written informed consent.


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None.


Authors' Contributions

M.K. contributed to the concept of the manuscript and drafted the manuscript. N.O. and A.Y. revised the manuscript and contributed to the concept of manuscript. R.K. and T.K. contributed to the obtainment and interpretation of the clinical information. All authors have read and approved the manuscript.




Publication History

Received: 19 April 2022

Accepted: 13 December 2022

Accepted Manuscript online:
05 January 2023

Article published online:
16 January 2023

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