case_images: PMC9805604_01
case_images: (a) Preoperative plain axial computed tomography scan showing subarachnoid hemorrhage in the interhemispheric fissure. (b) Preoperative sagittal magnetic resonance imaging shows the inferiorly directing aneurysm, the hyperintense lesion above it is a hematoma, while the hyperintense horizontal line below it is the optic chiasm. (c) Preoperative sagittal section cranial computed tomographic angiography showing the inferiorly directed anterior communicating artery aneurysm.
case_images: SNI-13-551-g001.jpg
case_images: PMC9805604_01_SNI-13-551-g001.jpg
case_images: F1
case_images: An imaging assessment was performed initially, her computed tomography (CT) scan showed an interhemispheric SAH, and the CT angiography showed a medium-sized inferiorly directing (AcomA) aneurysm [Figure 1].
case_images: An intraoperative image showing the relationship between the right optic nerve (blue star) with the inferiorly directing anterior communicating artery aneurysm (black star) adhering to the optic chiasm.
case_images: SNI-13-551-g002.jpg
case_images: PMC9805604_01_SNI-13-551-g002.jpg
case_images: F2
case_images: During surgery, it was observed that the inferiorly directing aneurysm was adherent to the optic chiasm, and the optic nerve had normal vascularity [Figure 2].
case_images: Diagnostic catheterization angiography 3 months after the operation showing the internal carotid arteries with intact ophthalmic arteries, visualized retinal blush (green and blue arrow) on both sides. (a) Right side. (b) Left side.
case_images: SNI-13-551-g003.jpg
case_images: PMC9805604_01_SNI-13-551-g003.jpg
case_images: F3
case_images: Three months after surgery, a diagnostic catheterization angiography revealed the complete aneurysm clipping without any residual neck; both ophthalmic arteries are visualized, and a bilateral retinal blush [Figure 3].