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The first 25 slides, exactly as they appear. The full deck has 52 content slides.
Ophthalmology
Intracranial Aneurysms and Carotid Cavernous Fistulae
Built from Khurana — Neuro-Ophthalmology
What’s inside
5 sections · 52 slides
Overview
- What this deck teaches you
Intracranial Aneurysms
A ballooned artery at the base of the brain
- What is an intracranial aneurysm?
- How common, how dangerous
- Ruptured vs unruptured - a crucial split
- Applied anatomy - where aneurysms sit
- The circle of Willis
- Why the eye doctor sees these first
- PCom artery against the oculomotor nerve
- Two ways an aneurysm causes symptoms
- The pupil-involving third nerve palsy
- A trap: the pupil can be spared at first
- Pain as a clue - and its limits
- When the aneurysm ruptures
- Compressive effects of intracranial aneurysms
- When an aneurysm presses on the visual pathway
Working Up an Aneurysm
From bedside suspicion to the right scan
- Investigations - who needs a scan urgently?
- First-line imaging: MRI vs CT
- Conventional (catheter) angiography - the gold standard
Treating the Aneurysm
Weighing the risk of the bulge against the risk of the repair
- Management - the ophthalmologist's role
- Balancing risk in small aneurysms
- Two ways to seal an aneurysm
- Complications shared by both repairs
Carotid-Cavernous Fistulae
When arterial blood short-circuits into a vein behind the eye
- What is a carotid-cavernous fistula (CCF)?
- Applied anatomy - the cavernous sinus
- Cross-section through the cavernous sinus
- The carotid arteries feeding the region
- Classification - direct vs indirect
- The Barrow classification (types A-D)
- Barrow classification of carotid-cavernous fistulae
- A second, clinical way to classify
- What causes a fistula?
- Pathophysiology - why the eye suffers
- Clinical features - the classic triad
- More signs of a direct fistula
- The subtle indirect (low-flow) fistula
- Damage to the front and back of the eye
- What else can look like a CCF?
- Investigations for a CCF
- Management - it starts with the fistula type
- Surgical and endovascular treatment
- Complications and the eye clean-up
- Why does a pupil-involving third nerve palsy demand urgent imaging?
- Key takeaways
- References (1/3)
- References (2/3)
- References (3/3)
- Neuro-Ophthalmology