Compression of the intracranial optic nerve by the supraclinoid internal carotid artery

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Blurred vision mainly on the right. The ophthalmological exam revealed normal pressure glaucoma.

Patient Data

Age: 50 years
Gender: Male

Asymmetrical size of the supraclinoid segment of the ICA (diametre 4.6 mm on the right and 3.6 mm on the left. The right supraclinoid internal carotid artery is higher as compared to the left, compressing the intracranial segment of the ipsilateral optic nerve which is displaced medially with normal diametre and no abnormal enhancement. Normal appearance of the left optic nerve and optic chiasma.

Annotated images:

  • red arrow: ICA
  • yellow arrow: intracranial segment of the optic neve

Case Discussion

MRI features of compression of the intracranial segment of the right optic nerve by the supraclinoid ICA in a patient with normal pressure glaucoma. This entity was already described in the literature. The vascular compression of the intracranial optic nerve by the ICA may be the cause of at least a risk factor for developing normal pressure glaucoma 1,2.

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