Vasospastic Amaurosis Fugax Diagnosed by Cerebral Angiography

We report a case of recurrent monocular blindness presumed to be caused by vasospasm, demonstrated by digital subtraction angiography. Case report: A 65-year-old man presented with recurrent visual loss in the left eye for 2 years. He had histories of hypertension, cigarette smoking, and May–Thurner...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2015-11, Vol.24 (11), p.e323-e325
Main Authors: Shim, Dong-Hyun, MD, Cha, Jae-Kwan, MD, Kang, Myung-Jin, MD, Choi, Jae-Hyung, MD, Nah, Hyun-Wook, MD
Format: Article
Language:English
Subjects:
Aged
Amaurosis fugax
Amaurosis Fugax - diagnosis
Amaurosis Fugax - etiology
Angiography, Digital Subtraction
Calcium-channel blocker
Cardiovascular
Cerebral angiography
Cerebral Angiography - methods
Humans
Male
Neurology
Ophthalmic Artery - diagnostic imaging
Vasospasm
Vasospasm, Intracranial - complications
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Summary:We report a case of recurrent monocular blindness presumed to be caused by vasospasm, demonstrated by digital subtraction angiography. Case report: A 65-year-old man presented with recurrent visual loss in the left eye for 2 years. He had histories of hypertension, cigarette smoking, and May–Thurner syndrome. The symptom occurred variably from twice a day to once a week and usually lasted for 5 minutes. Brain magnetic resonance imaging, magnetic resonance angiography, and ophthalmologic evaluation did not reveal any abnormality. Cerebral digital subtraction angiography was performed. On the left internal carotid angiogram, vasospasm occurred in the cervical portion of the left internal carotid artery and, subsequently, the blood flow to the left ophthalmic artery diminished. This phenomenon was reproducible and, in the absence of vasospasm, the ophthalmic artery was well visualized with no steno-occlusive lesion. Examination of the carotid duplex showed diffuse luminal narrowing and increased flow velocities in the left cervical internal carotid artery without atherosclerotic plaque. Treatment was started with nimodipine, which markedly reduced the attacks. Conclusion: We assumed that vasomotor instability, which made the vessels vulnerable to spasm, may have caused a recurrent ocular symptom in our patient.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2015.07.014