ABSTRACT
Doubts still exist concerning the mechanisms involved in ocular ischemic syndrome (OIS) and its dependence on carotid disease. We report findings from 14 surgical patients undergoing carotid artery reconstruction for symptomatic cerebrovascular disease. All of them had fluorescein angiography (FA) of the eye ipsilateral to the carotid operation before surgery and 3 months after to provide information regarding retinal circulation time. Before the surgical procedure, the mean circulation time was 29.4 ± 9.4 seconds (CI 95%: 24.5-34.3). After 3 months, a significant (P < .001) decrease in the circulation time was observed: 18.9 ± 8.4 seconds (CI 95%: 14.5-23.4). The present series demonstrates that carotid revascularization surgery improved retinal flow in approximately 80% of the patients.
Subject(s)
Carotid Artery Diseases/physiopathology , Carotid Artery Diseases/surgery , Cerebrovascular Disorders/physiopathology , Regional Blood Flow/physiology , Retinal Vessels/physiopathology , Aged , Carotid Artery Diseases/complications , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/surgery , Cohort Studies , Endarterectomy, Carotid , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To report a case of Wernicke's encephalopathy in a nonalcoholic woman with secondary hypoadrenalism. METHODS: A 58-year-old Italian woman developed Wernicke's syndrome secondary to recurrent vomiting due to secondary hypoadrenalism. RESULTS: Recurrent vomiting and resulting malnutrition caused a depletion of the patient's body stores of thiamine and the development of mental confusion and an oculomotor deficit. On the diagnostic suspicion of encephalitis in this patient with immunosuppression due to prolonged cortisone-based therapy, she underwent magnetic resonance imaging, which showed typical bilateral abnormal lesions pathognomonic of Wernicke's encephalopathy. The patient improved after parenteral administration of vitamin B1. CONCLUSIONS: Wernicke's encephalopathy must be regarded as a medical emergency that should be suspected in all cases presenting with a sudden deficit or lack of coordination of the ocular movements associated with ataxia and general degeneration of the mental faculties, in patients who have suffered recurrent vomiting or malnutrition for different reasons.
