Post-craniotomy blindness in the supine position: Unlikely or ignored?

Area of Science:

• Neurosurgery
• Ophthalmology
• Neurology

Background:

• Craniotomy in the supine position can lead to sudden visual loss, a rare but severe complication.
• The exact incidence and pathogenesis of post-craniotomy optic neuropathy remain unclear.
• Preventive and restorative interventions for this condition are not well-defined.

Observation:

• This report details a rare case of post-craniotomy optic neuropathy and sudden visual loss.
• The patient underwent craniotomy for an olfactory groove meningioma in the supine position.
• The case highlights the potential for visual complications in neurosurgical procedures.

Findings:

• The study discusses the possible pathophysiology of visual loss following supine craniotomy.
• It reviews existing literature on the pathogenesis, risk factors, and outcomes of this complication.
• Olfactory groove meningioma surgery in the supine position is identified as a potential risk scenario.

Implications:

• Neurosurgeons and neuroanesthesiologists need heightened awareness of this potential complication.
• Identifying high-risk patients is crucial for preventing devastating visual outcomes.
• Further research into pathogenesis and preventative strategies is warranted.