Supraclinoid Aneurysm Location, Symptoms, Causes, Treatment, ICD-10 & CPT Code

Intracranial aneurysms affect 5% of individuals, which makes this a serious health problem. However, ruptured aneurysms are a far less frequent event. Therefore, the majority of aneurysms either do not elicit any symptoms at all or produce symptoms that are brought on by other causes, most frequently the compression of surrounding structures.

These lesions often affect the frontal section of the circle of Willis, an area intimately linked to the visual pathway. A gradual reduction in visual acuity brought on by aneurysms in the supraclinoid region may occasionally be accompanied by ophthalmoplegia because of compression on the nerves that regulate the eyes.

Aneurysms are a type of lesion that frequently develop in the supraclinoid region of the carotid artery. Two potential problems that may emerge from growth and/or rupture are ophthalmoplegia and subarachnoid hemorrhage. Preventing subarachnoid hemorrhage and cranial nerve palsy are the main goals of treatment. Therapeutic options including endoluminal vessel repair by flow diverters have recently emerged as a promising alternative to open surgery, coil embolization, and deconstructive primary vascular occlusion.

What is Supraclinoid Aneurysm?

Supraclinoid aneurysm is a term used to describe an aneurysm that develops in the internal carotid artery. In some cases, these aneurysms take on a saccular shape, whereas in others they have a blister-like appearance (BLA). Ophthalmoplegia may result if they enlarge or bursts. Progressive vision loss may have a treatable underlying cause. In order to treat supraclinoid aneurysms, surgeons frequently utilize either endovascular coiling or surgical clipping.

Location

Aneurysms of the supraclinoid space are typically seen at the origin of the anterior choroidal artery or the posterior communicating artery. Due to their location in a deep and narrow surgical field, they might be challenging to access. They may show up as sessile lesions on the internal carotid artery's dorsal wall and can result in ophthalmoplegia and a gradual loss of visual acuity. Supraclinoid carotid artery aneurysms that have not ruptured are sometimes bilobate.

Symptoms

Supraclinoid aneurysm symptoms can include blurry vision in one or both eyes, trouble walking, dizziness, coordination problems or feeling off-balance, sensitivity or tingling in the face, arm, or leg, abrupt onset of a terrible headache, nausea and vomiting, neck stiffness, and momentary loss of vision or double vision. The mass effect of these aneurysms can cause neurological symptoms including headache and ophthalmoparesis, which can lead to vision loss.

Causes

Visual impairment is a common complication of supraclinoid aneurysms, a form of carotid artery aneurysms. Atherosclerosis is the most frequent cause of supraclinoid aneurysms, however other factors like hypertension, trauma, and congenital malformations can also contribute to this condition. Aneurysms that look like blisters, known as BLAs, can also develop on the supraclinoid portion of the internal carotid artery (ICA). In order to prevent rupture and lower the risk of stroke, supraclinoid aneurysms are commonly treated by clipping or coiling the affected artery.

Treatment

Endovascular therapy or surgical intervention is frequently used to treat supraclinoid aneurysms. Aneurysms can be treated surgically in a number of ways, including clipping (in which a metal clip is placed at the aneurysm's base to obstruct blood flow to the aneurysm) and open surgery (in which the aneurysm is cut out entirely). When treating an aneurysm endovascularly, a catheter is used to insert a coil or another occlusive device into the aneurysm in order to block the flow of blood. The choice of intervention is dependent on a variety of variables, including the aneurysm's size and location, the patient's general health, and the surgeon's preferences and experience. The aim of surgery is to stop the aneurysm from rupturing, which can cause fatal and significant health problems, including stroke.

Supraclinoid Aneurysm ICD-10

ICD-10 code I67.1 describes supraclinoid aneurysms. It is used to categorize unruptured cerebral aneurysms and other circulatory system abnormalities. It shouldn't be mistaken with I72.0, which stands for a carotid artery aneurysm.

Supraclinoid Aneurysm CPT Code

The precise therapy that is carried out will determine which CPT code is assigned to an operation involving a supraclinoid aneurysm. Common CPT codes associated with aneurysm treatment include:

61624: clipping of intracranial aneurysms, excluding clipping of middle cerebral artery aneurysms.

37191: Endovascular cerebral stent implantation with or without angioplasty with concurrent diagnostic and therapeutic imaging and/or procedures

61622: Removal of an intracranial aneurysm, using any technique