2023 Volume 51 Issue 5 Pages 442-447
Herein, we report a case of visual impairment following parent artery occlusion (PAO) of a ruptured collateral vessel aneurysm in a patient with Moyamoya disease. A 55-year-old woman who presented with headache and disorientation was diagnosed with a subdural hematoma and Moyamoya disease based on the results of magnetic resonance imaging, and was subsequently referred to our hospital. Digital subtraction angiography (DSA) revealed a pseudoaneurysm in the collateral vessels of the anterior ethmoidal artery; the aneurysm was identified as the source of subdural hematoma bleeding. Subsequently, parent artery occlusion (PAO) was performed under general anesthesia. DSA performed immediately after embolization confirmed disappearance of the aneurysm and allowed visualization of the central retinal artery and retinal choroidal brush. However, visual impairment was observed upon awakening from anesthesia. This case highlights that PAO of a ruptured aneurysm of the collateral vessels in Moyamoya disease should not be applied without full consideration, owing to the possibility of embolic complications.
