| Sudden blindness as a complication of percutaneous trigeminal procedures: mechanism analysis and prevention. | |
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MedLine Citation:
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PMID: 18928354 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The authors describe the case of a 76-year-old man in whom reversible sudden blindness developed after a percutaneous balloon compression rhizotomy for trigeminal neuralgia. His eye became tense and swollen with intraocular pressures of 66 mm Hg. Acetazolamide was administered, and visual acuity (20/50) returned within several months. Despite correct needle placement, the intraocular pressure rose acutely because of transient occlusion of the orbital venous drainage through the cavernous sinus; this was reversed with aggressive medical treatment. In cadaveric studies (dried skull and formalin-fixed head), the authors studied the mechanism of optic nerve penetration. Their findings showed that excessive cranial angulation of the needle with penetration of the inferior orbital fissure can directly traumatize the optic nerve in the orbital apex. Direct trauma to the optic nerve can therefore be prevented by early and repeated confirmation of the needle trajectory with lateral fluoroscopy before penetration of the foramen ovale. |
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Authors:
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Siviero Agazzi; Stanley Chang; Mitchell D Drucker; A Samy Youssef; Harry R Van Loveren |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 110 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-02 Completed Date: 2009-05-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 638-41 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, University of South Florida, Tampa, Florida 33606, USA. sagazzi@hsc.usf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acetazolamide
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therapeutic use Aged Blindness / etiology* Cadaver Humans Intraocular Pressure Male Optic Nerve Injuries / prevention & control Postoperative Complications Rhizotomy / methods* Trigeminal Nerve / surgery* Trigeminal Neuralgia / surgery* Visual Acuity / drug effects |
| Chemical | |
Reg. No./Substance:
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59-66-5/Acetazolamide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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