Journal français d'ophtalmologie
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Postoperative visual loss is a rare but disastrous complication that can be observed after spinal surgery. We report the case of a 39-year-old woman involved in a traffic accident that caused trauma to the cervical spine causing right hemiplegia, who underwent a prolonged spinal operation in the prone position and complained of monocular blindness 1 day postoperatively. ⋯ The symptoms did not completely disappear after 1 year of treatment. We consider the potential etiological factors contributing to this unilateral postoperative visual loss and suggest strategies to reduce the incidence of this complication in spinal surgery.
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Case Reports
[Dural arteriovenous fistula of the sigmoid sinus with a clinical expression on the opposite eye: A case report].
We report the case of an 87-year-old patient who developed a dural arteriovenous fistula of the sigmoid sinus with progressive exophthalmia in the opposite eye. The patient had a unilateral decrease in visual acuity; the vessels of the conjunctiva were dilated, and a progressive central retinal vein occlusion occurred in the left eye. A dural carotid cavernous fistula of the right sigmoid sinus was diagnosed with an angiography exam and was successfully treated with embolization of the arteriovenous shunt using Onyx(®). ⋯ Furthermore, it allows treatment of the fistula at the same time, the main complication being the embolization of normal vessels close to the abnormal shunt. The clinical expression of the dural arteriovenous fistula on the opposite eye is infrequent and is related to the presence of complex septae within the cavernous sinus, resulting in a bilateral drainage of the cerebral venous system. The early diagnosis and management of the disease is necessary to improve the visual prognosis.