Diagnosis and Management of Cerebral Venous Diseases in Neuro-Ophthalmology: Ongoing Controversies

Dinkin, Marc; Patsalides, Athos; Ertel, Monica

doi:10.22608/apo.2018239

Cited by 8 publications

(7 citation statements)

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“…On the one hand, thrombosis formation in CNS is associated with known CNS complications, and on the other hand, thrombosis can prevent the spread of infection, there is a risk of intracranial haemorrhage due to the angioinvasive nature of the fungus. As a result, no firm conclusions can be drawn about the use of systemic anticoagulants in the management of septic cerebral venous thrombosis in the context of CAM [ 8 , 21 ]. Routine use of antibiotics and prophylactic use of antiepileptic medication are not recommended [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…About three-fourths of them had diabetes as predisposing comorbidity and were treated for COVID-19 with corticosteroids [ 3 ]. The involvement of brain tissue may manifest as altered awareness, headache, unsteady gait, stroke, or seizures [ 7 , 8 ]. Once Mucorales first established in the nasal cavity and destroy the adjacent bone and soft tissues in this area, it proceeds to the maxillary and ethmoid sinuses, orbits, cavernous sinuses, meninges, and finally, the brain in terms of its angioinvasive propensity.…”

Section: Introductionmentioning

confidence: 99%

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From Bilateral Periorbital Necrotic Wound to Fungal Brain Abscess: A Complicated Case of COVID-19-Associated Mucormycosis

Eshraghi

Hosseini

Mohammadi

et al. 2022

Case Reports in Infectious Diseases

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COVID-19-associated mucormycosis (CAM) is categorized as rhinocerebral-orbital (RCOM), pulmonary, gastrointestinal, cutaneous, and disseminated mucormycosis. An alarming surge in morbidity and mortality attributed to mucormycosis concurrent with coronavirus disease 2019 (COVID-19) has emerged as a cause for concern during the current outbreak of COVID-19. The global incidence of CAM has been attributed to environmental, host, and iatrogenic factors. Further, Mucorales interacting with epithelial cells followed by endothelium invasion are pivotal in developing mucormycosis in patients with COVID-19. In essence, CAM is an emerging condition that requires increased vigilance in all COVID-19 patients, including those who have recovered. In this case report, we describe a rare case of CAM in a 33-year-old immunocompetent man who developed bilateral periocular pain and a small area of cutaneous necrosis in both medial canthi associated with impaired vision, which progressed into a fungal brain abscess formation in the post-COVID period. Furthermore, this case aims to illustrate the potential underlying risk factors of CAM other than known risk factors, especially in immunocompetent individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From Bilateral Periorbital Necrotic Wound to Fungal Brain Abscess: A Complicated Case of COVID-19-Associated Mucormycosis

Eshraghi

Hosseini

Mohammadi

et al. 2022

Case Reports in Infectious Diseases

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“…Studies have suggested that venous hypertension caused by venous thrombosis is the main cause of arteriovenous fistula, possibly related to the increase of venous pressure, leading to the opening of an original arteriovenous pathway or the angiogenesis of brain tissue caused by hypoxia ( 27 , 28 ). Another view is that CVT may be a secondary event caused by DAVFs ( 29 , 30 ), due to DAVF induced blood flow disorders, including venous congestion, blood stasis, venous turbulence, etc. In MRA examination, distinguishing the causal relationship between DAVF and CVT presents difficulties.…”

Section: Discussionmentioning

confidence: 99%

Differential subsampling with cartesian ordering: A high spatial-temporal resolution dixon imaging sequence for assessment of dural arteriovenous fistula

Chen

Wan

et al. 2022

Front. Neurol.

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ObjectiveTo evaluate the accuracy of differential subsampling with cartesian ordering (DISCO) in comparison to time of flight (TOF) in detecting dural arteriovenous fistulas (DAVF), cerebral venous thrombosis (CVT) and hemodynamics.MethodsSixty-two cases (24 female; aged 14–75; mean age, 51.3 years) were included in our study, with 42 positive and 20 negative cases via Digital Subtraction Angiography (DSA). Two neuroradiologists independently evaluated the DISCO and TOF. The sensitivity, specificity, and accuracy of the DISCO and TOF-MRA were individually calculated using DSA as the gold standard. Inter-observer reliability was assessed by using a weighted Cohen's kappa (κ) test; P < 0.05 was set as the threshold for statistical significance.ResultsDiagnostic sensitivities of DISCO and TOF for DAVF were 92.86 and 64.29%; specificities were 95.0% and 95.0%; while accuracies were 93.55 and 74.19% respectively. For detected CVT, sensitivities of DISCO and TOF were 100 and 92.31%; specificities were 96.55 and 93.10%; with accuracies 97.62 and 92.86% respectively. In hemodynamic analysis, sensitivity of DISCO for reflux was 95.45%; with a specificity of 95.0%; and accuracy 95.24%. The inter-observer kappa values were 0.857 for DISCO (P < 0.001).ConclusionDISCO showed a high degree of sensitivity and specificity, suggesting its effectiveness in detecting DAVF with or without CVT. Intracranial hemodynamics can be identified using DISCO in DAVF patients, providing accurate evaluation of cerebral blood flow dynamics during the pre-treatment phase.

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“…There are no trials; certain conclusions, however, can be drawn to aid in its management. 52 , 53 , 54 …”

Section: Medical Managementmentioning

confidence: 99%

COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee)

Malhotra

Gupta

Mehrotra

et al. 2021

Journal of Oral Biology and Craniofacial Research

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Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis has pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.

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Diagnosis and Management of Cerebral Venous Diseases in Neuro-Ophthalmology: Ongoing Controversies

Cited by 8 publications

References 0 publications

From Bilateral Periorbital Necrotic Wound to Fungal Brain Abscess: A Complicated Case of COVID-19-Associated Mucormycosis

From Bilateral Periorbital Necrotic Wound to Fungal Brain Abscess: A Complicated Case of COVID-19-Associated Mucormycosis

Differential subsampling with cartesian ordering: A high spatial-temporal resolution dixon imaging sequence for assessment of dural arteriovenous fistula

COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee)

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