Central retinal artery occlusion combined with posterior ciliary artery occlusion after preoperative embolization of the middle meningeal artery for intracranial meningioma: A case report

Medicine (Baltimore). 2020 Jul 10;99(28):e21197. doi: 10.1097/MD.0000000000021197.

Abstract

Rationale: Preoperative embolization of brain tumors has been widely used to minimize hemorrhaging during surgery, but anastomosis between vessels is sometimes overlooked and complications can occur. Herein we describe a case of rare complications of central retinal artery occlusion (CRAO) and posterior ciliary artery occlusion after embolization of the middle meningeal artery.

Patient concerns: A 48-year-old woman experienced acute, painless loss of vision in her left eye during embolization of the middle meningeal artery for meningioma.

Diagnosis: The patient was diagnosed with CRAO and posterior ciliary artery occlusion based on indirect ophthalmoscopy, optical computed tomography of the macula, and fundus angiography.

Interventions: Ocular massage, oral acetazolamide, and topical brimonidine eyedrops were administered.

Outcomes: Visual acuity decreased from hand motion to no light perception within 2 months. Optic disc atrophy with retinal thinning was evident after 2 to 4 months.

Lessons: The blood supply and any collateral vessels of the ophthalmic artery should be vigilantly scrutinized to prevent complications during embolization of the middle meningeal artery that may lead to a poor visual outcome.

Publication types

  • Case Reports

MeSH terms

  • Ciliary Arteries
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Humans
  • Meningeal Arteries
  • Meningeal Neoplasms / surgery*
  • Meningioma / surgery*
  • Middle Aged
  • Preoperative Care / adverse effects*
  • Retinal Artery Occlusion / etiology*