scholarly journals Postoperative visual loss following cerebral arteriovenous malformation surgery: a case report

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 27
Author(s):  
Nicolai Goettel ◽  
Jayati Ghosh ◽  
Michael Tymianski ◽  
Pirjo H Manninen
Keyword(s):  
Arteriovenous Malformation ◽  
Supine Position ◽  
Visual Loss ◽  
Ischemic Optic Neuropathy ◽  
Hemodynamic Stability ◽  
Field Assessment ◽  
Patient Reported ◽  
Ophthalmologic Examination ◽  
Computer Tomogram ◽  
Postoperative Visual Loss

We report the case of a 46 year-old woman presenting with unilateral postoperative visual loss after right frontal craniotomy for resection of an arteriovenous malformation in the supine position.The intraoperative course was uneventful with maintenance of hemodynamic stability. Blood loss was 300 ml; postoperative hemoglobin was 12.4 g/dl. In the recovery room, the patient reported loss of vision in her right eye. Ophthalmologic examination revealed decreased visual acuity, color vision, and visual field. Assessment of the retina was normal, but the patient showed a relative afferent pupillary defect consistent with the clinical diagnosis of ischemic optic neuropathy. Postoperative computer tomogram showed normal perfusion of ophthalmic artery and vein, no hemorrhage or signs of cerebral ischemia or edema. The patient recovered most of her vision 3 months after surgery.Anesthesiologists should be aware that this condition may follow uncomplicated intracranial surgeries in the supine position, and should obtain prompt ophthalmologic consultation when a patient develops postoperative visual loss.

scholarly journals Postoperative Visual Loss Following Spine Surgery: A Case Report

2019 ◽  
Vol 57 (218) ◽  
Author(s):  
Sabin Bhandari ◽  
Krishna Pokharel ◽  
Birendra Prasad Sah
Keyword(s):  
Visual Loss ◽  
Vision Loss ◽  
Pedicle Screw Fixation ◽  
Ischemic Optic Neuropathy ◽  
Ophthalmic Surgery ◽  
Intraoperative Hypotension ◽  
Posterior Ischemic Optic Neuropathy ◽  
One Year ◽  
The Right ◽  
Postoperative Visual Loss

Postoperative visual loss is a rare but devastating complication of non-ophthalmic surgery. Its aetiology is poorly understood and multiple associated factors have been proposed. We present a report of a 33-year-old female who developed irreversible diminution of vision on the right eye (non-arteritic-posterior-ischemic-optic-neuropathy) following general anaesthesia for pedicle screw fixation and plating for fracture vertebrae and hip in prone position and then screw placement for fracture calcaneum in supine position. The vision loss, limited to finger count close to face on the right eye, did not improve till follow-up at one-year. The combination of mild intraoperative hypotension, anaemia, prone positioning, prolonged surgery and anaesthesia may have contributed to postoperative visual loss in our patient.  

scholarly journals Unilateral postoperative visual loss in a patient undergoing hip arthroscopy in the supine position: a case report

2016 ◽  
Vol 69 (2) ◽  
pp. 197 ◽  
Author(s):  
Joohyun Lee ◽  
Ji-Hyun Chin ◽  
Won-Uk Koh ◽  
Young-Jin Ro ◽  
Hong-Seuk Yang
Keyword(s):  
Case Report ◽  
Supine Position ◽  
Hip Arthroscopy ◽  
Visual Loss ◽  
Postoperative Visual Loss

Postoperative Visual Loss in Spine Surgery

2018 ◽  
Author(s):  
David E. Traul
Keyword(s):  
Risk Factors ◽  
Spine Surgery ◽  
Visual Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Cortical Blindness ◽  
Ischemic Optic Neuropathy ◽  
Cardiac Procedures ◽  
Postoperative Visual Loss

Postoperative visual loss (POVL) is a rare but devastating condition associated with many types of nonocular surgery. In spine surgery, the most common causes of POVL are ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO), and cortical blindness. Although the association of POVL with spine surgery has long been recognized, the low incidence of this complication hinders the identification of patient and perioperative risk factors and limits our understanding of the causes of POVL. In adult spine surgery, POVL is most frequently attributed to ION whereas CRAO is more commonly seen in cardiac procedures. POVL due to cortical blindness has the highest incidence in pediatric spine surgery. While several risk factors for POVL have been identified in spine surgery, there are currently no standardized practice guidelines to eliminate the risk for POVL. Currently, there are no effective treatments for POVL, and recovery from ION and CRAO is limited.

The American Society of Anesthesiologists Postoperative Visual Loss Registry

2006 ◽  
Vol 105 (4) ◽  
pp. 652-659 ◽  
Author(s):  
Lorri A. Lee ◽  
Steven Roth ◽  
Karen L. Posner ◽  
Frederick W. Cheney ◽  
Robert A. Caplan ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spine Surgery ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Ischemic Optic Neuropathy ◽  
Bilateral Disease ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Postoperative Visual Loss

Background Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown. Methods To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases voluntarily submitted to the American Society of Anesthesiologists Postoperative Visual Loss Registry on standardized data forms. Results Ischemic optic neuropathy was associated with 83 of 93 spine surgery cases. The mean age of the patients was 50 +/- 14 yr, and most patients were relatively healthy. Mayfield pins supported the head in 16 of 83 cases. The mean anesthetic duration was 9.8 +/- 3.1 h, and the median estimated blood loss was 2.0 l (range, 0.1-25 l). Bilateral disease was present in 55 patients, with complete visual loss in the affected eye(s) in 47. Ischemic optic neuropathy cases had significantly higher anesthetic duration, blood loss, percentage of patients in Mayfield pins, and percentage of patients with bilateral disease compared with the remaining 10 cases of visual loss diagnosed with central retinal artery occlusion (P < 0.05), suggesting they are of different etiology. Conclusions Ischemic optic neuropathy was the most common cause of visual loss after spine surgery in the Registry, and most patients were relatively healthy. Blood loss of 1,000 ml or greater or anesthetic duration of 6 h or longer was present in 96% of these cases. For patients undergoing lengthy spine surgery in the prone position, the risk of visual loss should be considered in the preoperative discussion with patients.

scholarly journals Postoperative visual loss associated with spine surgery

2005 ◽  
Vol 15 (4) ◽  
pp. 479-484 ◽  
Author(s):  
Brian Gill ◽  
James E. Heavner
Keyword(s):  
Spine Surgery ◽  
Visual Loss ◽  
Postoperative Visual Loss

Migrainous infarction of the eye: Two cases of monocular ischemic complications associated with retinal migraine

Cephalalgia ◽  
2021 ◽  
pp. 033310242110562
Author(s):  
Nikita Chhabra ◽  
Chia-Chun Chiang ◽  
Marie A Di Nome ◽  
Odette Houghton ◽  
Rachel E Carlin ◽  
...  
Keyword(s):  
Visual Loss ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Monocular Vision ◽  
Ischemic Optic Neuropathy ◽  
Migrainous Infarction ◽  
Ischemic Complications ◽  
History Of

Background Retinal migraine is defined by fully reversible monocular visual phenomena. We present two cases that were complicated by permanent monocular vision deficits. Cases A 57-year-old man with history of retinal migraine experienced persistent monocular vision loss after one stereotypical retinal migraine, progressing to finger-count vision over 4 days. He developed paracentral acute middle maculopathy that progressed to central retinal artery occlusion. A 27-year-old man with history of retinal migraine presented with persistent right eye superotemporal scotoma after a retinal migraine. Relative afferent pupillary defect and superotemporal visual field defect were noted, consistent with ischemic optic neuropathy. Conclusion Retinal migraine can complicate with permanent monocular visual loss, suggesting potential migrainous infarction of the retina or optic nerve. A thorough cerebrovascular evaluation must be completed, which was unrevealing in our cases. Acute and preventive migraine therapy may be considered in retinal migraine patients, to mitigate rare but potentially permanent visual loss.

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