Radiological findings of orbital infarction syndrome following intracranial aneurysm surgery

Morofuji, Yoichi; Tsutsumi, Keisuke; Takahata, Hideaki; Kawahara, Ichiro; Hirao, Tomohito; Toda, Keisuke; Baba, Hiroshi

doi:10.1016/j.clineuro.2012.12.021

Cited by 12 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 16 ] OIS is most often the result of extensive ICA or common carotid artery atherothrombotic occlusions. [ 1 2 3 4 5 6 7 8 9 10 11 12 ] Other causes include craniotomies or endovascular procedures,[ 3 4 8 10 12 ] mucomycosis,[ 1 3 ] giant cell arteritis,[ 1 ] and sclerotherapy for vascular malformations. [ 11 ] For patients undergoing craniotomies, the mechanism of OIS is thought to be prolonged extensive pressure onto orbital tissues from improper positioning or direct orbital compression, resulting in inadequate tissue perfusion.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 3 4 5 6 ] Clinically, it is characterised by a sudden and profound vision loss, periorbital ache, blepharoptosis, total ophthalmoplegia, and chorioretinal ischemia. [ 1 2 3 4 5 6 7 8 9 10 11 12 ] Frequently, the site of arterial occlusion is the common or internal carotid artery (ICA), with very few cases reported due to isolated occlusion of the ophthalmic artery (OA). [ 1 2 3 4 5 6 7 8 9 10 11 12 ] Vascular occlusions are a known association of the novel SARS-CoV2 virus due its ability to induce a thrombogenic state.…”

mentioning

confidence: 99%

“…[ 1 2 3 4 5 6 7 8 9 10 11 12 ] Frequently, the site of arterial occlusion is the common or internal carotid artery (ICA), with very few cases reported due to isolated occlusion of the ophthalmic artery (OA). [ 1 2 3 4 5 6 7 8 9 10 11 12 ] Vascular occlusions are a known association of the novel SARS-CoV2 virus due its ability to induce a thrombogenic state. [ 13 ] One of the mainstays of treatment of COVID-19 involves the use of steroids.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Rao

Shetty

Nagesh

2021

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Orbital infarction syndrome is an uncommon pathology with devastating consequences. It is frequently secondary to atherothrombotic phenomena in the internal carotid artery. We report a case of a 66-year-old male with uncontrolled diabetes and use of systemic steroids for COVID-19, who presented with a sudden loss of vision in the left eye, with total ophthalmoplegia and diffuse opacification of the retina. On imaging, he was found to have features of rhino-orbital cellulitis with ischemia of the orbital tissue secondary to isolated ophthalmic artery obstruction (OAO) with a patent internal carotid artery. KOH mount of deep nasal swab was confirmatory of mucor. This is the first reported case of orbital infarction syndrome in the setting of COVID-19.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Rao

Shetty

Nagesh

2021

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…1 All cases had acharacteristicconstellationofsymptomsincludingseverevisionlossoftenNLP-completeophthalmoplegia,proptosisororbitalcongestion, andafundusexaminationconsistentwithaCRAO.Orbitalinfarctionsyndrome has been reported postoperatively after intracranial aneurysm clipping and spinal surgery as well as due to orbital cellulitis after transcanalicular dacryocystorhinostomy. [2][3][4] The mechanism for postsurgical orbital infarction syndrome is unclear. A myocutaneous flap is raised in these surgeries for the craniotomy, which may cause indirect or direct pressure on the orbits, resulting in hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

Acute Postoperative Visual Loss

2014

View full text Add to dashboard Cite

“…This rare disorder, with less than one hundred cases reported in literature, has been described in relation to infectious and inflammatory diseases, nephrotic syndrome, arterial dissection, hypoperfusion from common carotid artery occlusion and invasive procedures, such as aneurism surgery or endovascular mechanical thrombectomy (MT). [1][2][3][4][5][6][7][8][9][10][11][12][13][14] In 2015, five clinical trials showed the benefit of endovascular MT in acute large vessel occlusions. 15 Since then, an increasing number of stroke patients are being treated with MT and more potentially adverse events have been recognized.…”

Section: Introductionmentioning

confidence: 99%

Orbital inflammatory syndrome after mechanical thrombectomy of acute carotid occlusion

Silva¹,

Costa²,

Pinto³

et al. 2022

JNSK

View full text Add to dashboard Cite

Introduction: Orbital ischemic syndrome (OIS) is a rare disorder that presents with acute loss of visual acuity, chemosis, proptosis, ptosis and ophtalmoparesis. We present a case with acute onset of orbital inflammation following mechanical thrombectomy that mimicked an OIS, except for the absence of vision loss. Case report: A 65-year-old woman presented to our emergency department after an episode of transient dysarthria and left-sided hemiparesis and paresthesia that lasted about forty minutes. Head computed tomography showed no signs of intracranial bleeding or acute ischemia. CT angiogram showed occlusion of the right ICA terminus. Mechanical thrombectomy was then performed and the clot was removed with combined technique. Eight hours later, she developed orbital pain, ptosis, chemosis and complete ophthalmoplegia of the right eye. She had no diplopia, visual acuity and funduscopic examination were normal and there was no audible bruit in the orbit. Brain MRI performed showed hyperintensity of orbital fat along with hyperintensity and enlargement of all the extraocular There were no signs of orbital infarction and the optic nerve was structurally normal. Time of flight magnetic resonance angiography revealed reduced calibre of the distal portion of ICA, with associated contrast enhancement on vessel wall imaging. She was started on intravenous dexamethasone with full recovery two days later. Discussion: We present the case of an orbital inflammatory syndrome after mechanical thrombectomy. The mechanical stress exerted by endovascular devices has been associated with endothelial damage that correlates with vessel wall thickening and contrast enhancement in high resolution MRI studies. The temporal correlation with mechanical thrombectomy, the absence of vision loss or orbital infarction and the good clinical response to steroids support the hypothesis of an internal carotid artery wall inflammation due to endovascular manipulation of the stent retriever to be responsible for this acute orbital syndrome. This case highlights the need for close postprocedural monitoring after MT and the consideration of orbital inflammation secondary to endovascular devices in the differential diagnosis of an acute orbital syndrome. Further studies are needed to understand the long-term consequences of arterial wall lesions associated with these devices.

show abstract

Radiological findings of orbital infarction syndrome following intracranial aneurysm surgery

Cited by 12 publications

References 4 publications

Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Acute Postoperative Visual Loss

Orbital inflammatory syndrome after mechanical thrombectomy of acute carotid occlusion

Contact Info

Product

Resources

About