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Scripta Scientifica Medica

Transient monocular visual loss due to multiple CNS vascular pathology: report of two cases

A. Tzoukeva, F. Kirov, Ara Kaprelyan, T. Velinov, Silva Andonova

Abstract

BACKGROUND: The frequency of the transient monocular visual loss (TMVL), lasting minutes or longer, varies from a single to many episodes, which are usually followed by complete recovery of vision. TMVL is related most commonly o occlusive carotid disease. The therapy of patients with TMCL is divided into surgical and medical.

CASE1: A55-year-old female was admitted to the clinic, with 4 months history of TMVL of the right eye, lasting 2-3 minutes, followed by complete recovery. Neuro-ophthalmological examination was normal. Neuro imaging investigations revealed proximal part right internal carotid artery (ICA) stenosis of 70%, left ICA stenosis of 40%, King-King in the middle segment of ICA, causing stenosis of 14%, and incidental aneurysms of the intracranial part of right ICA andin M2 segment of right middle cerebral artery.

CASE2: A 74-year-old female was admitted to the clinic, with 1 year history of TMVL of the right eye, lasting 4-5 minutes, followed by complete recovery. Neuro-ophthalmological examination was normal. Duplex scaning showed hemodynamically significant stenosis of the right ICA, with King-Kingintheleft. MRI reveale diffuse vascular pathology.

CONCLUSION: These cases demonstrated a co-occurrence of hemodynamically significant carotid artery occlusion with multiple or diffuse vascular pathology in patients with TMVL. We suggest that the detailed history, neuro-ophthalmological, and neuroimaging examinations might be useful to determine the correct etiologic diagnosis and discuss the most effective therapeutic strategy in TMVL patients.

Scripta Scientifica Medica 2011;43(2):83-85


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DOI: http://dx.doi.org/10.14748/ssm.v43i2.391

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About The Authors

A. Tzoukeva
Medical University of Varna
Bulgaria

Department of Neurology

F. Kirov
Medical University of Varna
Bulgaria

Department of Neurology

Ara Kaprelyan
Medical University of Varna
Bulgaria

Department of Neurology

T. Velinov
Medical University of Varna
Bulgaria

Department of Radiology

Silva Andonova
Medical University of Varna
Bulgaria

Department of Neurology

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