1.A rare case of traumatic arteriovenous fistula between middle meningeal artery and spheno parietal sinus who presented with only chronic red eye and literature review
SengFai Tang ; WeiLoon Ng ; Umi Kalthum Mohd Noh ; Bastion Mae-Lynn Catherine ; Shahizon Azura Muhamed Mukari ; Hazlita Mohd Isa
Neurology Asia 2016;21(1):97-100
Traumatic middle meningeal arteriovenous fistula with sphenoparietal sinus involvement is very rare.
It is usually associated with skull fracture and intracranial hemorrhage. Ocular manifestation as sole
presentation is extremely rare and only a few cases have been reported. We report a case of traumatic
middle meningeal arteriovenous fistula with sphenoparietal sinus involvement 2 months after head
trauma, presenting with left eye redness and dilated corkscrew episcleral vessel. CT scan showed venous
out flow disturbance of the cavernous sinus with dilated ophthalmic veins. Transarterial endovascular
embolisation of the fistula was done successfully; clinical and 6 months MRA resolution was noted.
In conclusion, patient with traumatic middle meningeal arteriovenous fistula into the sphenoparietal
sinus can present solely with subtle ocular symptoms. Transarterial endovascular embolisation is an
effective procedure to close the fistula as seen in this case
Arteriovenous Fistula
2.Optic Neuropathy in Thyroid Eye Disease: A Case Series.
Nur Aqilah SALLEH ; Wong Hon SENG ; Hazlita Dato' Mohd ISA
Korean Journal of Family Medicine 2016;37(3):197-201
In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of their thyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze (Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatment may lead to or worsen thyroid ophthalmopathy. We report a case series of two patients with thyrotoxicosis, who presented with an atypical and subtle occurrence of thyroid eye disease (TED) soon after RAI therapy. One of the patients was initially diagnosed and treated for dry eyes; however, over a period of time, the patient's vision progressively deteriorated. Clinical and radiological investigations confirmed thyroid ophthalmopathy with low serum thyroid hormone levels. Both patients recovered well after immediate intensive intravenous steroid treatment. These cases highlight the importance of recognizing partial ptosis as one of the presenting signs of active TED among general practitioners and physicians.
Exophthalmos
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Eye Diseases*
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Eyelids
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General Practitioners
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Humans
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Hyperthyroidism
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Iodine
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Optic Nerve Diseases*
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Thyroid Diseases
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Thyroid Gland*
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Thyrotoxicosis