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Cerebral venous hypertension and blindness: a reversible complication
Salvador A Cuadra1, Frank T Padberg, Roger E Turbin
1University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA.
Journal of Vascular Surgery
|October 26, 2005
Summary
A functioning arteriovenous graft caused cerebral venous hypertension, leading to blindness in a renal disease patient. Occluding the graft restored vision, highlighting the link between vascular access and ocular health.
Area of Science:
- Nephrology
- Ophthalmology
- Vascular Surgery
Background:
- A patient with sarcoidosis-induced end-stage renal disease (ESRD) experienced complications following renal transplantation.
- Vascular access for hemodialysis, including prosthetic arteriovenous grafts, was maintained after initial transplant failure.
Observation:
- The patient developed progressive vision loss and bilateral papilledema two years post-transplantation.
- Ophthalmic evaluation revealed optic nerve edema and severe visual impairment.
Findings:
- Cerebral venous hypertension was diagnosed via arteriography and attributed to a patent right brachial to internal jugular arteriovenous graft.
- Permanent occlusion of the functioning graft led to the normalization of papilledema and significant visual recovery.
Implications:
- This case underscores the potential for vascular access complications to manifest as serious ocular conditions, such as blindness.
- Maintaining patent vascular access, particularly arteriovenous grafts, requires careful monitoring for systemic effects, including those impacting vision.
- Effective management of cerebral venous hypertension secondary to vascular access can lead to visual recovery.