Severe optochiasmatic arachnoiditis after rupture of an internal carotid artery aneurysm

Ramina, Ricardo; Arruda, Walter O.; Prestes, Antonio C. F.; Parolim, Mônica Konoke F.

doi:10.1590/s0004-282x1989000200011

Cited by 3 publications

(1 citation statement)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[15][16][17][18][19] Other causes of this devastating condition include sarcoidosis, subarachnoid haemorrhage, and foreign bodies such as muslin. [20][21][22][23] OCA has also been reported to occur in association with tumours such as craniopharyngiomas and pituitary adenomas. 15,25 Arachnoid cysts, arteriovenous malformations, multiple sclerosis and even exposure to radiant energy have all been implicated in the causation of this condition.…”

Section: )mentioning

confidence: 99%

Visual deterioration 1½ years after wrapping an un-clippable anterior communicating artery aneurysm: report of a case and review of the literature regarding opto-chiasmatic arachnoiditis

Ouma¹

2007

Afr. J. Psych

View full text Add to dashboard Cite

Case report A middle-aged lady presented with a subarachnoid haemorrhage due to a ruptured anterior communicating artery aneurysm. At surgery it was found to be unclippable and was wrapped with oxidized cellulose muscle and fibrin sealant. Oneand-a-half years later she returned complaining of severe, progressive bilateral visual loss. The general physical examination was unremarkable. Her peripheral blood examination and chest X ray were normal. She had pale optic discs with a visual acuity of 6/36 in the left and 6/60 in the right eye. Magnetic resonance imaging scan of the brain demonstrated a granulomatous inflammatory lesion around the area of the aneurysm as well as marked involvement of the optic nerves, chiasm and tracts (Figures 1-4). The lesion was not biopsied as she was reluctant to subject herself to another surgical procedure. She was placed on a course of steroids with little benefit on follow-up over a period of 18 months. Discussion Aneurysms of the anterior circle of Willis especially ophthalmic segment internal carotid artery aneurysms, cavernous sinus aneurysms and anterior communicating artery aneurysms are well documented as causes of loss of visual acuity. 1 Anterior communicating artery aneurysms may affect visual acuity by a number of mechanisms. 1) They may cause direct compression of the optic nerve and/or optic chiasm. 1-9

show abstract

Section: )mentioning

confidence: 99%

Visual deterioration 1½ years after wrapping an un-clippable anterior communicating artery aneurysm: report of a case and review of the literature regarding opto-chiasmatic arachnoiditis

Ouma¹

2007

Afr. J. Psych

View full text Add to dashboard Cite

show abstract

Progressive visual loss due to a muslinoma – report of a case and review of the literature

Berger¹,

Hartmann

Wildemann³

2003

Euro J of Neurology

View full text Add to dashboard Cite

Intracranial internal carotid artery (ICA) aneurysms are frequently treated either by microsurgical clipping of the aneurysm neck, by endovascular coiling of the aneurysm sac or by balloon occlusion of the parent vessel. For some broad-based aneurysms that may not be suitable for any of these options, microsurgical wrapping of the aneurysm wall with muslin or gauze rarely is applied. We report the case of a patient who suffered from a minor stroke because of arterio-arterial embolism from an intracranial ICA aneurysm. The aneurysm was treated by wrapping muslin material. After 12 months, he experienced progressive visual loss. Cranial magnetic resonance testing magnetic resonance tomography (MRT) revealed a granulomatous inflammation surrounding the site of the aneurysm and affecting optochiasmatic structures. A muslin-induced optic neuropathy is a rare but serious complication of a chronic inflammatory reaction in response to muslin or gauze used in intracranial aneurysm wrapping. If the foreign body inflammatory reaction to muslin or gauze leads to a mass formation, the term muslinoma or gauzoma is applied. Various treatment strategies include surgery, steroids and cyclophosphamide, but recovery of the vision is not predictable. As a consequence, muslin or cotton gauze should only be applied with great caution in neurovascular surgery.

show abstract

The leptomeninges as a critical organ for normal CNS development and function: First patient and public involved systematic review of arachnoiditis (chronic meningitis)

Palackdkharry¹,

Wottrich²,

Dienes³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background & importance This patient and public-involved systematic review originally focused on arachnoiditis, a supposedly rare “iatrogenic chronic meningitis” causing permanent neurologic damage and intractable pain. We sought to prove disease existence, causation, symptoms, and inform future directions. After 63 terms for the same pathology were found, the study was renamed Diseases of the Leptomeninges (DLMs). We present results that nullify traditional clinical thinking about DLMs, answer study questions, and create a unified path forward. Methods The prospective PRISMA protocol is published at Arcsology.org. We used four platforms, 10 sources, extraction software, and critical review with ≥2 researchers at each phase. All human sources to 12/6/2020 were eligible for qualitative synthesis utilizing R. Weekly updates since cutoff strengthen conclusions. Results Included were 887/14286 sources containing 12721 DLMs patients. Pathology involves the subarachnoid space (SAS) and pia. DLMs occurred in all countries as a contributor to the top 10 causes of disability-adjusted life years lost, with communicable diseases (CDs) predominating. In the USA, the ratio of CDs to iatrogenic causes is 2.4:1, contradicting arachnoiditis literature. Spinal fusion surgery comprised 54.7% of the iatrogenic category, with rhBMP-2 resulting in 2.4x more DLMs than no use (p<0.0001). Spinal injections and neuraxial anesthesia procedures cause 1.1%, and 0.2% permanent DLMs, respectively. Syringomyelia, hydrocephalus, and arachnoid cysts are complications caused by blocked CSF flow. CNS neuron death occurs due to insufficient arterial supply from compromised vasculature and nerves traversing the SAS. Contrast MRI is currently the diagnostic test of choice. Lack of radiologist recognition is problematic. Discussion & conclusion DLMs are common. The LM clinically functions as an organ with critical CNS-sustaining roles involving the SAS-pia structure, enclosed cells, lymphatics, and biologic pathways. Cases involve all specialties. Causes are numerous, symptoms predictable, and outcomes dependent on time to treatment and extent of residual SAS damage. An international disease classification and possible treatment trials are proposed.

show abstract

Severe optochiasmatic arachnoiditis after rupture of an internal carotid artery aneurysm

Cited by 3 publications

References 13 publications

Visual deterioration 1½ years after wrapping an un-clippable anterior communicating artery aneurysm: report of a case and review of the literature regarding opto-chiasmatic arachnoiditis

Visual deterioration 1½ years after wrapping an un-clippable anterior communicating artery aneurysm: report of a case and review of the literature regarding opto-chiasmatic arachnoiditis

Progressive visual loss due to a muslinoma – report of a case and review of the literature

The leptomeninges as a critical organ for normal CNS development and function: First patient and public involved systematic review of arachnoiditis (chronic meningitis)

Contact Info

Product

Resources

About