Clipping of a giant partially thrombosed ophthalmic segment aneurysm

Ophthalmic segment aneurysms (OSA) originate from the paraclinoid portion of the internal carotid artery (ICA) usually at the origin of the ophthalmic artery. OSAs represent 1.5–10% of intracranial aneurysms, and although often asymptomatic, may lead to optic nerve (ON) compression and/or subarachnoid hemorrhage. When the dome is partially or completely thrombosed, microsurgical clipping can provide vascular exclusion and ON decompression through thrombectomy. Nevertheless, high expertise and knowledge of the regional anatomy are required to manage this complex surgical field.