Ophthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy

Bilateral Orbital Compartment Syndrome Following a Craniotomy With Coronal Incision

“…2,6,7 Recently, another theory has proposed that external pressure leads to orbital venous congestion, which in turn reduces perfusion pressure and eventually causes compressive optic neuropathy and associated arterial occlusion. [8][9][10] In fact, the exact incidence of OCS after neurosurgery is not well established. Some of the risk factors for the development of OCS include long duration in the prone position, flap compression, and the use of retraction devices during surgery, while orbital compression by the flap is considered to be the most important cause.…”

“…On this basis, further studies concluded that its possible mechanism was a rapid increase in intraorbital pressure caused by various reasons, which led to the central artery occlusion, as well as direct compression of the optic nerve and its nutrient vessels, resulting in irreversible visual loss 2,6,7 . Recently, another theory has proposed that external pressure leads to orbital venous congestion, which in turn reduces perfusion pressure and eventually causes compressive optic neuropathy and associated arterial occlusion 8–10 . In fact, the exact incidence of OCS after neurosurgery is not well established.…”

“…In fact, the exact incidence of OCS after neurosurgery is not well established. Some of the risk factors for the development of OCS include long duration in the prone position, flap compression, and the use of retraction devices during surgery, while orbital compression by the flap is considered to be the most important cause 8,10,11 . In this patient, wet cotton gauze was placed under the skin flap to prevent flap necrosis, which may have increased compression in the orbit.…”