PMC3323856_01
Visual fields of the patient at presentation. The RE is normal, and the LE shows a deep central scotoma (V/A 20/40).
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Visual fields examination (Humphrey 24-2 SITA standard) was normal in the right eye and revealed a deep central scotoma in the left eye (Figure 1).
Axial T1-weighted MRI revealing the giant internal carotid aneurysm.
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 Emergency MRI and consequent selective digital angiography confirmed the presence of a giant aneurysm of 28 mm of diameter, arising from the supraclinoid part of the left internal carotid and a second smaller aneurysm of 9 mm diameter with a wide base near the origin of the left ophthalmic artery (Figures 2 and 3).
3-dimensional digital angiography illustrating the double aneurysm.
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 Emergency MRI and consequent selective digital angiography confirmed the presence of a giant aneurysm of 28 mm of diameter, arising from the supraclinoid part of the left internal carotid and a second smaller aneurysm of 9 mm diameter with a wide base near the origin of the left ophthalmic artery (Figures 2 and 3).
Digital angiography of the aneurysms after the second successful embolization.
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An additional, totally successful, embolization was performed (Figure 4).
Visual field of the LE 20 months after successful embolism (V/A 20/25).
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The patient's symptoms gradually recessed, and, at 20 months followup, visual acuity is 20/25 with significant improvement of visual fields findings (Figure 5).