Transient blindness following epidural analgesia

Abstract

SummaryA 43-year-old

A case of vertebrobasilar stroke during oxygen-ozone therapy

“…Various reports describe cases of transient bilateral or monocular blindness after epidural injections, but all are related to increase in intracranial pressure leading to retinal hemorrhages. 3 It is accepted that epidural venous placement of the needle can go unrecognized during lumbar procedures. This would allow accidental intravenous injection of air.…”

Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic—a case report and review of the literature

“…The remaining anesthesia-related VHR cases were associated with epidural injections [6,7,9,8,12]. Although some of these patients also received general anesthetics for these injections, the proposed mechanism for the hemorrhage was increased retinal venous pressure secondary to increased intracranial pressure due to displacement of cerebrospinal fluid in the spinal canal.…”

“…In addition, VHR may be asymptomatic, especially if the macular hemorrhages are extrafoveal or extramacular, and the patient would not be examined. Thus, this phenomenon may be underreported [10,12,13,42,57,58].…”

“…Valsalva hemorrhagic retinopathy has also been reported after common medical and surgical interventions including the following: colonoscopy [15], upper endoscopy [16,17], laparoscopy [4,11], laparoscopic cholecystectomy [5], prostate biopsy [50], dental procedures [18,19], lumbar and caudal epidural injection [6][7][8][9][10]12], a seizure [51], choking and an attempted Heimlich maneuver [52], and cardiopulmonary resuscitation (CPR) [53].…”

“…Postoperative visual loss may occur after common interventions and has been previously reported after a number of seemingly benign and common anesthetic-related maneuvers [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”