Long-term progressive deterioration of visual function after papilledema improved by embolization of a dural arteriovenous fistula in the sigmoid sinus: a case report

Journal of Medical Case Reports

Masayoshi Iwaki²  Muneyoshi Yasuda¹  Takashi Inukai¹  Kazuhiro Murata²  Masahiro Zako² 

[1] Department of Neurological Surgery, Aichi Medical University, Nagakute, Aichi, Japan;Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan

关键词: Visual function;    Sigmoid sinus;    Papilledema;    Dural arteriovenous fistula;   

Others  :  1180961
DOI  :  10.1186/1752-1947-8-392

 received in 2014-03-30, accepted in 2014-09-22,  发布年份 2014

【 摘 要 】

Introduction

It is generally believed that people affected by papilledema will not have progressive damage to their eyesight if they receive adequate medical care to treat the underlying cause of the papilledema. We present a case that appears to contradict this widely accepted belief.

Case presentation

A 53-year-old Japanese man with tinnitus visited our hospital. His initial best-corrected visual acuity in either eye was not impaired, although they both exhibited papilledema. Magnetic resonance imaging did not reveal a mass or hemorrhagic lesion in our patient’s brain. Nevertheless, his best-corrected visual acuity gradually deteriorated over the following three months. Angiography demonstrated a dural arteriovenous fistula in his sigmoid sinus. After embolization therapy, the papilledema improved in both eyes. However, over the subsequent four years, his best-corrected visual acuity progressively deteriorated due to an unknown cause, despite the successful embolization of the dural arteriovenous fistula.

Conclusion

There may be delayed onset of an unknown pathophysiology in the visual system after treatment for the underlying cause of papilledema, implying an uncertain visual prognosis for patients with this condition.

【 授权许可】

   
2014 Zako et al.; licensee BioMed Central Ltd.

【 图 表 】

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