Assuntos
Doenças do Nervo Abducente , Fístula Carótido-Cavernosa , Seio Cavernoso , Embolização Terapêutica , Exoftalmia , Humanos , Fístula Carótido-Cavernosa/diagnóstico por imagem , Fístula Carótido-Cavernosa/terapia , Doenças do Nervo Abducente/etiologia , Doenças do Nervo Abducente/terapia , Seio Cavernoso/diagnóstico por imagem , Exoftalmia/etiologia , Exoftalmia/terapia , Embolização Terapêutica/efeitos adversosRESUMO
We report a rare, potentially sight-threatening ocular complication due to central venous stenosis related to a previous site of haemodialysis catheter. A dialysis-dependent woman in her 60s presented with left eye redness for 1 month followed by a remarkably prominent vessel on the left upper eyelid for 2 weeks. Examinations found left eyelid oedema with prominent venous dilatation on the upper eyelid as well as left eye mild proptosis, conjunctiva injection with corkscrew vessels, raised intraocular pressure, and dilated and tortuous retina vessels. Central thoracic venogram showed total occlusion on the left brachiocephalic vein with retrograde reflux to the jugular vein. An endovascular percutaneous transluminal balloon angioplasty was performed for the left brachiocephalic vein stenosis, which resolved the orbital, facial and neck venous congestion. The patient remained asymptomatic after 1 year.
Assuntos
Besouros , Doenças Orbitárias , Feminino , Animais , Humanos , Constrição Patológica/etiologia , Diálise Renal , Veias Jugulares , Veias Braquiocefálicas/diagnóstico por imagem , PálpebrasRESUMO
Sixteen syndrome is rare variant of one and a half syndrome resulting from lesion affecting bilateral dorsal pontine structures. This report describes a case of 16 syndrome in systemic lupus erythematosus (SLE). A 28 year old woman with underlying lupus was presented with sudden left side body weakness and diplopia. Examination showed features of 16 syndrome with one and a half syndrome, facial diplegia and left hemiparesis. Neuroimaging revealed an acute infarct of bilateral dorsal pons. The patient was placed on antiplatelet therapy. However, she developed left leg deep vein thrombosis and pulmonary embolism after one week. She was then given subcutaneous low molecular weight heparin, followed by warfarin and cycles of cyclophosphamide. Her hemiparesis, ocular symptoms, and facial diplegia improved after one year. SLE increases the risk of stroke and thrombotic events in a young patient. Achieving disease remission is important to prevent stroke in SLE patients.