ABSTRACT
PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Subject(s)
Aged, 80 and over , Humans , Male , Arterial Occlusive Diseases/diagnosis , Brain Diseases/complications , Fatal Outcome , Functional Laterality , Magnetic Resonance Imaging , Mucormycosis/complications , Ophthalmic Artery/pathology , Orbital Diseases/complications , Paranasal Sinus Diseases/complicationsABSTRACT
PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Subject(s)
Aged, 80 and over , Humans , Male , Arterial Occlusive Diseases/diagnosis , Brain Diseases/complications , Fatal Outcome , Functional Laterality , Magnetic Resonance Imaging , Mucormycosis/complications , Ophthalmic Artery/pathology , Orbital Diseases/complications , Paranasal Sinus Diseases/complicationsABSTRACT
Analisam-se 51 pacientes portadores de 55 aneurismas paraclinóideos (APC) submetidos a tratamento cirúrgico. Em decorrência de tratar-se de procedimento de alta complexidade, descrevemos em pormenor os seus aspectos técnicos. O processo clinóideo anterior foi removido por via extradural após secção da duplicação dural da tenda da fissura orbitária superior e/ou por via intradural. Conseguiu-se exclusão do APC nos 51 pacientes. Em dois casos a clipagem foi parcial e, em três, ocorreu oclusão da ACI. Em 42 (82 por cento) pacientes ocorreu bom resultado; em 5 (10 por cento), incapacidade moderada; em 1 (2 por cento), incapacidade grave e três (6 por cento) faleceram por infarto cerebral. Sete (13,7 por cento) pacientes tiveram lesão adicional do nervo óptico, sendo parcial em 4 (7,7 por cento) e total em 3 (6 por cento).
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Craniotomy , Carotid Artery, Internal/surgery , Intracranial Aneurysm/surgery , Microsurgery/methods , Ophthalmic Artery/surgery , Cerebral Angiography , Carotid Artery, Internal/pathology , Carotid Artery, Internal , Intracranial Aneurysm/pathology , Intracranial Aneurysm , Ophthalmic Artery/pathology , Ophthalmic Artery , Subarachnoid Hemorrhage/pathologyABSTRACT
Con el objetivo de analizar la velocidad pico sistólica máxima en la arteria oftálmica que tiene aneurisma en su emergencia, se realizó un estudio por Doppler dúplex en 28 segmentos arteriales carotídeo - oftálmicos sin estenosis carotídea ipsilateral. Se usó la angiografía del sistema carotídeo extra e intracraneal como estándar. Se identificó un grupo de ocho arterias oftálmicas de siete individuos con velocidad pico sistólica máxima (VPSM) significativamente reducida (p=0,006) comparada con la velocidad pico sistólica del grupo normal. Utilizando una VPSM de la arteria oftálmica para diagnosticar aneurisma en su emergencia, el valor de 19 cm/s ofrece una sensibilidad de 80 por ciento y una especificidad de 100 por ciento. Se concluye que el Doppler duplex tiene utilidad diagnóstica en la identificación de pacientes portadores de aneurisma en la emergencia de la arteria oftálmica y sin estenosis carotídea grave ipsilateral.