| Title |
A Case of Posterior Ischemic Optic Neuropathy in a Posterior-draining Dural Cavernous Sinus Fistula |
| Creator |
Hashimoto, M; Ohtsuka, K; Suzuki, Y; Hoyt, WF |
| Affiliation |
Department of Ophthalmology, Sapporo Medical University, Japan. mashoyu5@beige.plala.or.jp |
| Abstract |
A 79-year-old woman presented with sudden unilateral visual loss after an ocular motor disturbance and pulsatile tinnitus. Neuro-ophthalmologic examination showed a presumed right posterior ischemic optic neuropathy (PION), oculosympathetic, and third, sensory fifth, and sixth cranial nerve pareses. Selective angiography of the right internal and external carotid arteries confirmed a posterior-draining dural carotid cavernous sinus fistula (CCF) fed by the right meningohypophyseal trunk and right middle meningeal artery. Angiography also showed an ophthalmic-middle meningeal arterial anastomosis. We postulate that the PION was caused by an arterial steal, because blood was drawn into the fistula and away from the intraorbital optic nerve. |
| Subject |
Older people; Blindness, etiology; Carotid Artery, External, abnormalities; Carotid Artery, External, radiography; Carotid Artery, Internal, abnormalities; Carotid Artery, Internal, radiography; Carotid-Cavernous Sinus Fistula, complications; Carotid-Cavernous Sinus Fistula, diagnosis; Carotid-Cavernous Sinus Fistula, therapy; Central Nervous System Vascular Malformations, complications; Central Nervous System Vascular Malformations, diagnosis; Central Nervous System Vascular Malformations, therapy; Cerebral Angiography; Cranial Nerve Diseases, etiology; Embolization, Therapeutic; Female; Humans; Magnetic Resonance Imaging; Optic Neuropathy, Ischemic, diagnosis; Optic Neuropathy, Ischemic, etiology; Optic Neuropathy, Ischemic, therapy |
| Format |
application/pdf |
| Publication Type |
Journal Article |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/ |
| Publisher |
Lippincott, Williams & Wilkins |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
© North American Neuro-Ophthalmology Society |
| Setname |
ehsl_novel_jno |
| ID |
225431 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s69058t8/225431 |
