Document Detail


Pathophysiology of visual disturbances occurring after foam sclerotherapy.
MedLine Citation:
PMID:  20870875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Visual disturbances (VDs) are reported with an average rate of 1.4% after foam sclerotherapy (FS). Some clinical clues indicate that they could correspond to migraine with aura (MA).
AIMS: To validate the hypothesis that VDs occurring after FS correspond to MA and are not transient ischaemic cerebro-vascular events.
METHOD: A prospective multicentre study was carried out by the French Society of Phlebology in collaboration with the Neurology Department of the Marseille University Hospital (France). We included prospectively and consecutively all patients who experienced VDs after FS using air to make the foam. The patients were assessed (1) clinically with a specific form describing procedures of FS and recording neurological symptoms, later analysed by a neurologist specialized in migraine; and (2) by a brain diffusion-weighted magnetic resonance imaging (MRI) (T1, T2, T2*, diffusion) carried out within two weeks and analysed by a neuroradiologist.
RESULTS: Twenty patients, 16 women and four men, were included in 11 phlebology clinics. All kinds of veins were treated. VDs occurred in average seven minutes after FS. Clinical assessment showed that VDs presented characteristics of MA in all patients, with headache in 10 and without in 10. Paresthesia was observed in five patients and dysphasic speech disturbance in one. Fifteen patients (75%) had a personal history of migraine. Fifteen MRIs were performed within two weeks (mean: 8 days) and three were late (26 days). All of them were normal. MRI was not performed in two patients.
CONCLUSION: These results show that VDs occurring after FS correspond to MA and are not transient ischaemic cerebro-vascular events. We suggest a pathophysiological hypothesis resting on the release of endothelin that would reach the cerebral cortex through a paten foramen ovale.
Authors:
J L Gillet; A Donnet; M Lausecker; J M Guedes; J J Guex; P Lehmann
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Phlebology / Venous Forum of the Royal Society of Medicine     Volume:  25     ISSN:  1758-1125     ISO Abbreviation:  Phlebology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2011-02-01     Revised Date:  2011-11-10    
Medline Journal Info:
Nlm Unique ID:  9012921     Medline TA:  Phlebology     Country:  England    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  IM    
Affiliation:
Vascular Medicine - Phlebology, 51 bis Avenue Professeur Tixier, 38300 Bourgoin-Jallieu, France. gilletjeanluc@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Endothelins / metabolism
Female
Headache
Humans
Incidence
Ischemic Attack, Transient
Magnetic Resonance Imaging
Male
Middle Aged
Migraine with Aura / diagnosis*,  etiology
Prospective Studies
Sclerotherapy / adverse effects*
Chemical
Reg. No./Substance:
0/Endothelins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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