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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Subarachnoid hemorrhage and vasospastic stroke after self-enucleation
1Arizona Centre Plastic Surgery, Tucson, Arizona, USA. kotlus@gmail.com
Ophthalmic Plastic and Reconstructive Surgery
|September 21, 2007
Summary
A psychotic episode led to self-enucleation of an eye, causing optic nerve avulsion and brain injury. This case highlights severe neurological complications following traumatic eye removal.
Area of Science:
- Ophthalmology
- Neurology
- Trauma Surgery
Background:
- Self-enucleation is a rare and severe form of self-harm.
- Psychotic episodes can precipitate extreme behaviors with significant physical consequences.
Observation:
- A 31-year-old woman with acute psychosis self-enucleated her left eye.
- Computed tomography (CT) revealed optic nerve avulsion, chiasmal edema, and subarachnoid hemorrhage.
Findings:
- Surgical exploration via transconjunctival orbitotomy resulted in the removal of the globe and 4.8 cm of the optic nerve.
- Postoperatively, the patient experienced contralateral visual loss, middle cerebral artery vasospasm, and bilateral cortical infarcts.
Implications:
- This case underscores the critical need for prompt psychiatric and neurosurgical intervention in cases of self-inflicted eye trauma.
- Understanding the potential for severe neurological sequelae, including ischemic events, is crucial for managing such complex cases.
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