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KMID : 1141120160020020090
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The Nerve
2016 Volume.2 No. 2 p.90 ~ p.92
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Post-cranioplasty Blindness
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Lee Eun-Hye
Kim In-Kyeoung
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Abstract
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Acute visual loss resulting from an uncomplicated cranioplasty is rare. A 52-year-old man presented with computed tomography (CT)-proven acute subdural hematoma in the right frontotemporoparietal area. The patients got a standard craniotomy in supine position. But on postoperative day 24, he was diagnosed postoperative epidural and subdural empyema. The patient underwent infected bone flap removal and evacuation of epidural and subdural empyema. Four months later, he got right frontotemporoparietal cranioplasty with artificial bone (Medpor) after controlling of infection. But on postoperative day 15, he complained of inability to see with his right eye. Brain and orbital CT, magnetic resonance imaging scan performed postoperatively did not show any new intracranial or intraorbital pathology. There were not any adverse events such as excessive pressure placed on the eyeball or bulky retraction of frontal skin flap. Visual evoked potential revealed prechiasmatic lesion. Fundoscopy showed slightly pallor optic disc of right side. The patient’s vision in the right eye remained no light perception permanently. The reason and pathophysiology of the mechanism of this complication should be discussed through reporting more cases.
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KEYWORD
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Brain, Craniotomy, Empyema, subdural, Evoked potentials, visua, Eye, Humans, Magnetic resonance imaging, Male, Pallor, Polyethylenes, Subdural space, Supine position, Tomography, X-ray computed, Medpor
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