Open AccessOphthalmic artery occlusion due to orbital compartment syndrome after a frontotemporal craniotomy
Author(s) -
Lauren N DeMaria,
Ann Q. Tran,
Andrea A. Tooley,
Aliaa H. Abdelhakim,
Irina Belinsky,
Eleanore T Kim
Publication year - 2021
Publication title -
indian journal of ophthalmology. case reports
Language(s) - English
Resource type - Journals
eISSN - 2772-3089
pISSN - 2772-3070
DOI - 10.4103/ijo.ijo_1982_20
Subject(s) - medicine , craniotomy , surgery , frontal lobe , occlusion , ophthalmic artery , extraocular muscles , anatomy , radiology , blood flow , psychiatry
A 32-year-old female with a right frontal lobe glioma underwent an elective frontotemporal craniotomy. One hour postoperatively, the patient developed a right orbital compartment syndrome (OCS) with unilateral acute vision loss, proptosis, afferent pupillary defect, and complete ophthalmoplegia. The patient underwent emergent lateral canthotomy and inferior cantholysis. Neuroimaging revealed extensive vascular congestion along the extraocular muscles at the orbital apex. Retinal imaging demonstrated an ophthalmic artery occlusion. OCS following a frontal or frontotemporal craniotomy relates to increased orbital venous congestion from direct compression of the myocutaneous flap and subsequent intraorbital pressure elevation, vascular compromise, and ocular ischemia.