Letter to the Editor: Commentary on Coil Embolization of Traumatic Ophthalmic Artery Aneurysm: Case Report (Korean J Neurotrauma 2022;18:98-102).

Dear Editor,

Thank you for the opportunity to review the paper, titled “Coil Embolization of Traumatic Ophthalmic Artery Aneurysm: Case Report.” Traumatic intracranial aneurysm is extremely rare, and occurrence in the ophthalmic artery is even rarer. The standard treatment of traumatic ophthalmic artery aneurysms has not yet been established. Therefore, I believe that this report will be useful in establishing and deciding on the management of traumatic ophthalmic artery aneurysms. However, I believe that there will be an issue of debate regarding this case. According to the phrase “The author decided the aneurysm being unruptured state because it had not less likely to cause SAH from anatomical location. It located close to anterior clinoid process and dural ring in extradural region (in CASE REPORT session),” the author has judged that the dense subarachnoid hemorrhage (SAH) in the basal cistern was induced by traumatic insult. However, the author has described that the growing ophthalmic artery aneurysm was in an unruptured state, even during its inducing and growing after head trauma. It seems that the author has judged traumatic SAH and accompanied trauma-induced ophthalmic artery unruptured aneurysm during its growing. If this judgment was based on the relationship between the ophthalmic artery orifice (OAO), anterior clinoid process (ACP), and distal dural ring (DDR), additional images should be provided for evidence. For example, maximum intensity projection images to observe the ACP and OAO, and magnetic resonance image to confirm the location of the DDR would be useful.123) Supplementary brain imaging studies could clarify the case explanations and validity for the decision of the author.