Insinuate Orbital Cellulitis Associated With Diesel Explosion-Induced Injury

Abstract Background: Diesel-related orbital cellulitis is uncommon, it has an insinuate appearance whereas develops aggressively, leading to severe vision loss or poor reconstruction. Here we present a case of diesel explosion-associated eyelid trauma with toxic orbital cellulitis, who at last obtained relatively sound vision and appearance after several rounds of surgeries, which is rarely seen for the trauma itself. Case presentation: A 33-year-old male was injured in the right eye by diesel engine explosion. He was initially treated for right eye eyelid laceration however the trauma developed into toxic orbital cellulitis on the next day. Orbital debridement and removing of the orbital residual diesel fluid was performed on him immediately. However, on the second day necrosis developed in the eyelid and sub-dermal tissue. Therefore he received another orbital debridement to remove the necrotized tissue and awaited the subsequent right eyelid skin grafting surgery. The patient finally got his right eye vision saved as well as maintaining a relatively sound structure of the eyelid.Conclusion: Timely debridement and removing the residual diesel in the orbit is necessary for the recovery of patient with diesel-related toxic orbital cellulitis.

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Complete Vision Loss following Orbital Cellulitis Secondary to Acute Dacryocystitis

Case Reports in Ophthalmological Medicine ◽

10.1155/2016/9630698 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Margaret L. Pfeiffer ◽

Alexander Hacopian ◽

Helen Merritt ◽

Margaret E. Phillips ◽

Karina Richani

Keyword(s):

Visual Acuity ◽

Vision Loss ◽

Orbital Cellulitis ◽

Close Monitoring ◽

Light Perception ◽

Lacrimal Sac ◽

Surgical Incision ◽

Incision And Drainage ◽

Severe Vision Loss ◽

Prompt Diagnosis

We present a case of a 50-year-old woman with acute dacryocystitis that was complicated by posterior rupture of the lacrimal sac causing an orbital cellulitis with subsequent visual acuity of no light perception. Upon presentation, she was immediately started on broad-spectrum antibiotics and underwent surgical incision and drainage of the lacrimal sac abscess but never regained vision. There are 4 cases in the literature of permanent severe vision loss from acute dacryocystitis. Prompt diagnosis and close monitoring of acute dacryocystitis are therefore essential to prevent extension into the orbit and possible optic nerve compromise.

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Expanded endoscopic endonasal transpterygoid transmaxillary approach for a giant trigeminal schwannoma

Neurosurgical Focus: Video ◽

10.3171/2020.4.focusvid.19904 ◽

2020 ◽

Vol 2 (2) ◽

pp. V15

Author(s):

Rafael Martínez-Pérez ◽

Marcus Zachariah ◽

Ruychen Li ◽

Giuliano Silveira-Bertazzo ◽

Ricardo L. Carrau ◽

...

Keyword(s):

Vision Loss ◽

Direct Access ◽

Total Removal ◽

Endoscopic Endonasal ◽

Temporal Fossa ◽

Secondary Invasion ◽

Trigeminal Schwannoma ◽

Severe Vision Loss ◽

The Right ◽

Neurovascular Structures

Atypical trigeminal schwannomas (ATSs) are notorious for their ability to invade the skull base. An expanded endoscopic endonasal approach (eEEA) provides direct access to the tumor with no need for cerebral retraction or manipulation of neurovascular structures. Herein, we present a case of a large temporal fossa extradural lesion with secondary invasion of the sella, clivus, and temporal and infratemporal fossae in a 49-year-old male with severe vision loss. A transpterygoid transmaxillary approach was performed. Gross-total removal was achieved and pathology revealed the diagnosis of ATS. Visual function fully recovered in the right side and the patient has been uneventfully followed since surgery.The video can be found here: https://youtu.be/6pSwdYsN9hk.

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Pseudomonas aeruginosa endophthalmitis caused by accidental iatrogenic ocular injury with a hypodermic needle

Journal of International Medical Research ◽

10.1177/0300060517694570 ◽

2017 ◽

Vol 45 (2) ◽

pp. 882-885

Author(s):

Cheng-wei Lu ◽

Ji-long Hao ◽

Xiu-fen Liu ◽

Ling-ling Liang ◽

Dan-dan Zhou

Keyword(s):

Vision Loss ◽

Hypodermic Needle ◽

Ocular Infection ◽

Ocular Injury ◽

Antibiotic Administration ◽

Hand Motion ◽

Severe Vision Loss ◽

The Right ◽

Type Of Injury

Iatrogenic traumatic endophthalmitis is a rare but serious ocular infection that can lead to severe vision loss. A 44-year-old man presented with pain and decreased vision in the right eye 4 hours after injury with a hypodermic needle during irrigation of his eye. Slit-lamp examination revealed a penetrating corneal puncture and iris hole in the right eye. Twenty hours later, his visual acuity had decreased to hand motion, and severe fibrinoid uveitis was noted. He immediately underwent irrigation of the anterior chamber and intravitreal antibiotic injection. The right eye became painful again, and emergent vitrectomy combined with lensectomy was performed along with intravitreal antibiotic administration. The patient remained stable during the 2-month follow-up. Standard practice should be adopted when irrigating the eye to prevent this type of injury, and emergent surgical intervention is very important to preserve visual function.

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Rhino-orbital mucormycosis during steroid therapy in COVID-19 patients: A case report

European Journal of Ophthalmology ◽

10.1177/11206721211009450 ◽

2021 ◽

pp. 112067212110094

Author(s):

Amirreza Veisi ◽

Abbas Bagheri ◽

Mohammad Eshaghi ◽

Mohamad Hasan Rikhtehgar ◽

Mozhgan Rezaei Kanavi ◽

...

Keyword(s):

Amphotericin B ◽

Visual Loss ◽

Vision Loss ◽

Case Presentation ◽

Radiologic Findings ◽

First Case ◽

Lung Injuries ◽

The Right ◽

Prompt Diagnosis ◽

Complete Ophthalmoplegia

Purpose: To report two cases of COVID-19 under treatment with a corticosteroid; in one case rhino-orbitocerebral mucormycosis and in another one rhino-orbital mucormycosis developed. Case presentation: A 40-year old woman and a 54-year old man with severe COVID-19 underwent corticosteroid therapy for immune-related lung injuries. The first case presented with a bilateral visual loss and complete ophthalmoplegia of the right eye. The second case presented with vision loss, proptosis, orbital inflammation, and complete ophthalmoplegia on the left side. Histopathologic, nasal endoscopic examinations, and radiologic findings confirmed mucormycosis in both patients. The patients denied orbital exenteration and were managed with systemic amphotericin B and daily endoscopic sinus debridement and irrigation with diluted amphotericin B. Because of the intracranial space involvement, the first case died. The second case was successfully managed surgically and medically. Conclusion: Rhino-orbital/cerebral mucormycosis may be developed in COVID-19 patients under treatment with corticosteroid, and requires prompt diagnosis and management.

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A Case of Onset and Treatment on Purtscher’s Retinopathy in a Single Eye

10.21203/rs.3.rs-809949/v1 ◽

2021 ◽

Author(s):

Ting Yuan ◽

Haitong Lian ◽

Chao Gao

Keyword(s):

Vision Loss ◽

Case Reports ◽

Cotton Wool ◽

Medical Treatments ◽

Case Presentation ◽

Traumatic Injuries ◽

Chest Injuries ◽

Purtscher’S Retinopathy ◽

Cotton Wool Spots ◽

The Right

Abstract Background:Purtscher’s retinopathy is an occlusive microvasculopathy caused by traumatic injuries, especially like head and chest injuries. The exact mechanism of injury remains unclear, and Most case reports about Purtscher’s retinopathy focused on the symptoms of fundus, and did not provide detailed medical treatments. Case presentation: In this case, the patient suffered suddenly vision loss in the right eye one day after a traffic accident with moderate head and chest injuries. Ocular examinations revealed typical characteristics of cotton wool spots, and minimal intraretinal hemorrhages around the optic disc. 5 different drugs were used in this patient. 15 days after the treatment (corticosteroids and traditional Chinese medicine), the vision of the patient was improved and the symptoms (cotton wool spots, hemorrhages, retinal edema and visual field) were alleviated obviously. Conclusions: Corticosteroids and traditional Chinese medicines used in our case did improve the vision of the patient, and alleviated the symptoms of fundus.

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Embolization of the false lumen using IMPEDE-FX embolization plugs as part of treatment of an infrarenal post-dissection aneurysm: a case report

CVIR Endovascular ◽

10.1186/s42155-020-00183-6 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Anne-Jet S. Jansen ◽

Paul M. van Schaik ◽

Jasper M. Martens ◽

Michel M. P. J. Reijnen

Keyword(s):

Case Report ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

False Lumen ◽

True Lumen ◽

Case Presentation ◽

Type A Dissection ◽

Prospective Trials ◽

The Right ◽

Embolization Procedure

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.

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Effective erector spinae plane block for postoperative analgesia in a pyothorax patient who underwent emergency re-open thoracotomy—a case report

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-019-0044-8 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Izumi Kawagoe ◽

Daizoh Satoh ◽

Mariko Fukui ◽

Kenji Suzuki ◽

Eiichi Inada

Keyword(s):

Postoperative Analgesia ◽

Transverse Process ◽

Erector Spinae ◽

Open Thoracotomy ◽

Case Presentation ◽

Lung Lobectomy ◽

Erector Spinae Plane Block ◽

Lower Lung ◽

The Right ◽

Vein Stenosis

Abstract Background The appropriate choice of postoperative analgesia for pyothorax surgery is unclear since local infection could contaminate the catheter used for regional blocks and bacteremia can lead to disordered coagulation. We performed erector spinae plane block (ESPB) in a pyothorax patient undergoing emergency re-open thoracotomy. Case presentation An 81-year-old male with internal jugular vein stenosis on aspirin therapy was scheduled for pyothorax drainage and residual middle lobectomy 14 days after he underwent open right lower lung lobectomy for lung cancer. ESPB was performed with injection of 20 ml of 0.375% levobupivacaine at the Th5 transverse process of the right side under ultrasound guidance. Although he needed intravenous pentazocine for pain on postoperative day 0, no more analgesics were required postoperatively. NRS score ranged from 0 to 1 thereafter. Conclusions ESPB provided effective postoperative analgesia following emergency re-open thoracotomy for our pyothorax patient. ESPB might be the appropriate choice for postoperative analgesia following pyothorax surgery.

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Proning related bilateral anterior ischaemic optic neuropathy in a patient with COVID-19 related acute respiratory distress syndrome

BMC Ophthalmology ◽

10.1186/s12886-021-02028-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kirsty Michelle Clarke ◽

Vivi Riga ◽

Amy-lee Shirodkar ◽

Joel Meyer

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Visual Field ◽

Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Vision Loss ◽

Prone Positioning ◽

Disc Oedema ◽

Ischaemic Optic Neuropathy ◽

The Right

Abstract Background Non-arteritic ischaemic optic neuropathy (NAION) is a rare but harmful complication of prone positioning. Prone mechanical ventilation is a therapeutic strategy which has been used extensively during the COVID-19 pandemic to treat acutely hypoxemic patients with COVID-19 related acute respiratory distress syndrome (ARDS). Though a small number of cases of unilateral NAION have been reported in patients testing positive for the SARS-CoV-2 virus, we describe what is to our knowledge, the first reported case of bilateral NAION occurring in a patient proned extensively for the treatment of COVID-19 related ARDS. We consider the potential aetiological factors leading to NAION after prone mechanical ventilation in patients with COVID-19 and suggest strategies to protect against its development. Case presentation : We report a case of severe, irreversible, visual impairment secondary to bilateral anterior ION in a fifty-five-year-old male who underwent eight episodes of prone mechanical ventilation to treat COVID-19 related ARDS. Once weaned from his sedation he reported bilateral painless vision loss, and bedside ophthalmological assessment identified a reduced visual acuity of 3/30 unaided in the left eye and counting fingers in the right. Dilated indirect ophthalmoscopy revealed inferotemporal optic disc oedema with splinter haemorrhages in the right eye and mild disc oedema, temporal pallor, and nerve fibre layer haemorrhages inferiorly in the left eye. Humphrey visual field 24 − 2 testing confirmed a severely constricted visual field with macular sparing on the right and depressed inferonasal vision with preserved peripheral vision on the left eye. OCT disc imaging shortly after diagnosis revealed bilateral disc swelling and flame haemorrhages in the right eye. Conclusions NAION is a devastating, but preventable complication of prone positioning, which may pose significant risk of vision loss in patients with COVID-19 related ARDS.

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Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1729996 ◽

2021 ◽

Author(s):

Sima Sayyahmelli ◽

Zhaoliang Sun ◽

Emel Avci ◽

Mustafa K. Başkaya

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Skull Base ◽

Vision Loss ◽

Internal Carotid ◽

Extent Of Resection ◽

World Health ◽

Who Grade ◽

The Right ◽

Supraclinoid Internal Carotid Artery

AbstractAnterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it might be possible to remove the tumor from the artery wall despite complete encasement or narrowing, the decision of whether the tumor can be safely separated from the arterial wall ultimately must be made intraoperatively.The patient is a 75-year-old woman with right-sided progressive vision loss. In the neurological examination, she only had light perception in the right eye without any visual acuity or peripheral loss in the left eye. MRI showed a homogeneously enhancing right-sided anterior clinoidal mass with encasing and narrowing of the supraclinoid internal carotid artery (ICA). Computed tomography (CT) angiography showed a mild narrowing of the right supraclinoid ICA with associated a 360-degree encasement. The decision was made to proceed using a pterional approach with extradural anterior clinoidectomy and optic unroofing. The surgery and postoperative course were uneventful. MRI confirmed gross total resection (Figs. 1 and 2). The histopathology was a meningothelial meningioma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence and has shown improved vision at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/vt3o1c2o8Z0

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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