Optic Neuropathy due to Intracranial Dolichoectasia A Case Series

Dolichoectasia, also known as dilatative arteriopathy, comes from the greek words dolichos (elongated) and ectasia (dilated). Several proposed mechanisms of injury causing cranial neuropathies due to dolichoectasia include: direct compression of the nerve, impaired circulation by direct compression of smaller feeder vessels, obliteration of nutrient vessels derived from the diseased artery, and emboli. Visual pathway compression by internal carotid artery and vertebrobasilar dolichoectasia has been reported. We describe three patients with compressive optic neuropathy due to supraclinoid ICA dolichoectasia, and a fourth patient with transient blood pressure spikes and associated left homonymous hemianopia thought to be due to VBD.