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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Near-total or total blindness caused by chronic ocular ischemia is a well-recognized complication of severe atherosclerotic occlusive disease of the carotid artery (CA) but has not been previously reported in the English-language literature as a sequela of an occlusive CA injury. This report describes a patient who sustained a gunshot wound to the neck, which injured the ipsilateral internal CA, external CA, and vertebral artery. The location of the injuries precluded arterial repair. The patient was neurologically intact after operative exploration. Twenty months after the injury a marked loss of vision in the ipsilateral eye was detected. Chronic ocular ischemia was diagnosed from clinical findings and ophthalmoscopic examination results. Knowledge that chronic ocular ischemia and blindness can occur after an occlusive CA injury supports the use of primary arterial repair for all CA injuries. In those instances in which repair is not technically possible, frequent ophthalmoscopic examinations and testing of visual acuity should be used postoperatively to diagnose ocular ischemia; thus treatment to prevent the loss of sight can be carried out.
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PMID:Monocular blindness after penetrating trauma to the carotid artery. 274 3

Bilateral blindness resulting from optic atrophy is an unusual complication following shock and cardio-respiratory arrest. This report describes a patient with acute respiratory failure due to pneumococcal pneumonia being treated with very high levels of positive end expiratory pressure who developed bilateral blindness following cardiac arrest. This unfortunate complication most likely resulted from increased intraocular pressure and low systemic perfusion pressure synergistically causing ischemia of the optic nerves.
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PMID:Bilateral optic atrophy after cardiac arrest in a patient with acute respiratory failure on positive pressure ventilation. 283 2

Patients presenting with elevated intracranial pressure (ICP) and papilledema in reality harbor a large degree of simple optic disc protrusion. Evaluations with dynamic CT demonstrate that there is depressed perfusion of the optic papilla in severe increased ICP in subjects with papilledema/protrusion as opposed to normal patients. This supports the theory that increased ICP leads to blindness by the mechanism of an increased pressure gradient at the optic nerve head resulting in ischemia and irreversible optic nerve atrophy.
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PMID:Papilledema. Neuroradiologic evaluation of optic disc protrusion. 298 Apr 89

The etiology of monocular ischemia influences the clinical manifestation and long-term neurologic and visual prognosis. During a 10-year period, 140 patients with monocular visual symptoms were evaluated and assigned to a carotid bifurcation occlusive disease group (group I) or a primary ocular disease group (group II) on the basis of angiographic findings and ophthalmologic evaluation. Patients with symptoms secondary to emboli from the carotid bifurcation tended to have a shorter duration of blindness and a lower incidence of permanent blindness initially and during follow-up. The presence of Hollenhorst plaques or retinal artery occlusion did not have any discriminatory diagnostic value since the incidence was similar in both patient groups. Since both primary eye disease and carotid bifurcation occlusive disease can be initially seen as monocular ischemia, carotid angiography and ophthalmologic consultation are necessary to select those patients who will benefit from carotid endarterectomy.
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PMID:Monocular ischemia--the influence of carotid atherosclerosis versus primary ocular disease on prognosis. 341 79

A 25-year-old white man presented with acute multiple sclerosis manifested by right blindness, difficulty urinating, and paresthesias and weakness of both legs. Retinal examination revealed a distal occlusion of the descending branch of the superior temporal arteriole leading to an area of retinal ischemia of the right eye. The optic disc was edematous, and there were focal areas of periphlebitis. All retinal signs resolved in three weeks, and the only abnormality that persisted was a pale right optic disc. The finding of small arteriolar disease is unusual and may represent another possible pathogenetic mechanism in multiple sclerosis.
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PMID:Retinal arteriolar occlusion in multiple sclerosis. 371 37

The involvement of the posterior circulation in moyamoya disease was studied in 178 patients. Forty-three had several types of disturbance such as visual field defect, decreased visual acuity, episodes of blindness, and scintillating scotomata. Most of these symptoms were attributed to occlusive lesions in the posterior circulation. Visual disturbances were seen more often in patients with a juvenile onset than in cases of adult onset. Superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis and encephalomyosynangiosis (EMS) improved the cerebral perfusion both in the anterior and posterior circulation by redistribution of blood. In most cases, the visual symptoms subsided or were stabilized after STA-MCA anastomosis and EMS. These surgical procedures did not, however, lead to direct revascularization in cases of ischemia in the visual cortex. In five patients with impending blindness, transplantation of the omentum to the occipital lobe led to improved vision.
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PMID:Study of the posterior circulation in moyamoya disease. Part 2: Visual disturbances and surgical treatment. 376 Sep 53

Cardiopulmonary arrest is a test of the brain's tolerance to global ischemia. New insights into the pathophysiology of global ischemia have led to the potential use of early prophylactic anticonvulsants, hypothermia, barbiturate coma, glucose manipulations, calcium-blocking agents, and hemodilution. A wide spectrum of neurologic sequelae may follow global ischemia, ranging from brain death, vegetative states, and impairment of higher intellectual function to syndromes of amnesia and cortical blindness, post-anoxic myoclonus, delayed leukoencephalopathy, and spinal stroke. The distinctive features of these sequelae and their pathophysiologic aspects are discussed. Special attention is given to brain death and prognostication.
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PMID:Cardiopulmonary arrest. Pathophysiology and neurologic complications. 390 62

Fourteen (1.8%) of more than 800 children evaluated in a Visually Impaired Program over 10 years became permanently blind during an episode of raised intracranial pressure secondary to shunt malfunction. Visual symptoms and papilledema were recognized in only three children at the onset of blindness. Clinical and radiologic findings suggested that the loss of sight was caused by a lesion in the pregeniculate pathway in nine patients, probably due to ischemia; five children in the postgeniculate group sustained infarcts of the occipital lobes. These cases highlight the importance of parent education and prompt treatment of raised intracranial pressure due to shunt malfunction.
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PMID:Permanent visual loss after shunt malfunction. 396 98

Both ictal nystagmus and cortical blindness may occur transiently in acute cerebral disorders and therefore escape clinical detection, particularly in confused, agitated patients. The following case report describes a young woman with chronic myelogenous leukemia who became progressively ill following bone marrow transplantation. During the course of her illness, acute ictal nystagmus developed from focal right occipital ischemia; postictally she remained cortically blind with possible visual hallucinations for 48 hours.
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PMID:Cortical blindness following ictal nystagmus. 397 48

Venous stasis retinopathy and ischemic oculopathy are ocular manifestations of ischemia in the distribution of the carotid artery. While not as common as transient monocular blindness or retinal arterial emboli, they are readily recognizable and indicate the presence of severe, often bilateral, carotid occlusive disease. Patterns of occlusion vary but usually include complete occlusion of at least one common or internal carotid artery, often accompanied by occlusion or narrowing in the opposite carotid system. The ocular findings in venous stasis retinopathy and ischemic oculopathy indicate ongoing ocular ischemia and may progress to intractable neovascular glaucoma. Therapy, individualized for the specific pattern of occlusive changes, may be directed toward prevention of stroke or may be indicated primarily for the reversal of ocular ischemia and prevention of blindness secondary to neovascular glaucoma.
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PMID:Chronic ocular ischemia and carotid vascular disease. 402 85


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