Bispectral index sensor as a possible cause of postoperative visual loss after frontal craniotomy

Yamashita, S.; Takahashi, Hiroaki; Tanaka, Masao

doi:10.1093/bja/aep153

Cited by 5 publications

(5 citation statements)

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“…[91013] Choudhari et al .,[13] reported a patient who awoke blind following a 3-hour long pterional craniotomy for an AcomA aneurysm. The authors proposed the ongoing external pressure on the ipsilateral eye as the main mechanism for post-operative sudden visual loss.…”

Section: Discussionmentioning

confidence: 99%

“…Several other authors have reported sudden monocular visual loss due to the external pressure on the eyes in the supine position. [9,10,13] Choudhari et al, [13] reported a patient who awoke blind following a 3-hour long pterional craniotomy for an AcomA aneurysm. The authors proposed the ongoing external pressure on the ipsilateral eye as the main mechanism for post-operative sudden visual loss.…”

Section: Discussionmentioning

confidence: 99%

“…Different names, such as post-decompression optic neuropathy, orbital infarction syndrome and postoperative visual loss (PVL), have been used by some[7–10] to explain the possible contributing mechanisms leading to the blindness. Although this has shed some light on the issue, the nature of this complication still remains elusive.…”

Section: Introductionmentioning

confidence: 99%

“…Despite initial description of the complication by some authors [3][4][5][6] in the 1970's with their experience after ventriculography or ventricular decompression procedures, its importance has been neglected in the literature thereafter. Different names, such as post-decompression optic neuropathy, orbital infarction syndrome and postoperative visual loss (PVL), have been used by some [7][8][9][10] to explain the possible contributing mechanisms leading to the blindness. Although this has shed some light on the issue, the nature of this complication still remains elusive.…”

Section: Introductionmentioning

confidence: 99%

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Post-craniotomy blindness in the supine position: Unlikely or ignored?

et al. 2013

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Immediate visual loss following craniotomy in the supine position is a disastrous complication in neurosurgical patients. The incidence is unknown and little is known on the definite pathogenesis. Also, preventive or restorative interventions are unclear. We describe the rare case of post-craniotomy optic neuropathy and sudden visual loss after craniotomy in the supine position for an olfactory groove meningioma, discuss the possible pathophysiology and review the literature on the pathogenesis, risk factors, and outcome. Although rare, neurosurgeons, as well as neuroanesthesiologists should be aware of the possibility of this devastating complication in the high-risk group of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Post-craniotomy blindness in the supine position: Unlikely or ignored?

et al. 2013

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“…В научной литературе также описаны случаи послеоперационной потери зрения в результате непосредственного внешнего давления кожного лоскута на глазное яблоко в ходе операции, что приводило к возникновению синдрома орбитального инфаркта с последующей слепотой [5][6][7][8].…”

Section: Russian Journal Of Neurosurgeryunclassified

Cases of vision loss after bifrontal access

Varfolomeev

Дубовой

Соснов

et al. 2019

Nejrohirurgiâ (Mosk.)

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The objective is to present 2 clinical cases of complete vision loss after bifrontal access during craniotomy due to vascular brain pathology.Materials and methods. In one case, a bifrontal skin incision was used during subfrontal craniotomy to remove frontal lobe arteriovenous malformation, in the other one – to apply intracranial side-to-side anastomosis between A3 segments of both anterior cerebral arteries, and to clip proximal aneurysms of the anterior connecting artery and the anterior cerebral artery on the right. After the surgery, patients developed bilateral amaurosis and ophthalmoplegia. We analyzed data on patients’ general clinical condition and their ophthalmological status prior to the surgery, as well as surgical videos and anesthesia records.Results. Intraoperative iatrogenic damage of cranial nerves and arteries was excluded. We distinguished that a suspected intraoperative factor, playing a decisive role, was a piece of skin applying direct pressure on the eyeballs. It was removed during the surgery.Conclusion. To prevent the development of such a complication as vision loss, it is necessary to carefully evaluate all possible risks at preoperative and intraoperative stages. During the surgery, all organs and systems at risk should be monitored. It is important to prevent a sudden drop in blood pressure and massive blood loss. During craniotomy, any eyeballs compression must be avoided.Conflict of interest. The authors declare no conflict of interest.Informed consent. All patients gave written informed consent to publication of their data.

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