Ruptured Internal Carotid Artery–Ophthalmic Artery Aneurysm Associated with Medial Deviation of the Internal Carotid Artery at the C2 Segment: A Case Report

Authors:
Open Access
Publisher website
Google Scholar
Abstract
Objective: We report a ruptured internal carotid artery–ophthalmic artery (ICA–OphA) aneurysm in which morphological variation of the C2 segment, including marked medial deviation of the ICA, was suggested to be associated with aneurysm formation and may have influenced the endovascular strategy.Case Presentation: A 52-year-old woman presented with subarachnoid hemorrhage. CTA revealed a right ICA–OphA aneurysm accompanied by pronounced medial deviation of the right ICA at the C2 segment. This deviation created an acutely angled ICA–OphA bifurcation, with the OphA originating from the medial aspect of the ICA. Emergency coil embolization was performed, and the aneurysm was successfully occluded.Conclusion: The patient exhibited well-developed anterior clinoid process and optic strut morphology, which may have contributed to medial deviation of the ICA and to aneurysm formation at the ICA–OphA bifurcation. Recognition of such morphological variations is important because they may obscure OphA visualization and affect device selection. In these settings, preshaped S-type microcatheters may facilitate stable catheterization and safe coil embolization.

This publication has 11 references indexed in Scilit: