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[Orbital varix presenting orbital apex syndrome]
No Shinkei Geka. Neurological Surgery
|February 1, 1995
Summary
Orbital varix presenting as orbital apex syndrome is rare. Surgical removal of the impinging vein relieved retro-ocular pain and ptosis, though vision was impacted.
Area of Science:
- Neurology
- Ophthalmology
- Vascular Surgery
Background:
- Orbital varix typically causes intermittent proptosis.
- Orbital apex syndrome involves cranial nerve deficits at the orbital apex.
Observation:
- A 61-year-old female presented with acute double vision, retro-ocular pain, and right oculomotor palsy.
- Initial CT and MRI were normal; angiography showed no lesion.
- A subsequent CT revealed a mass at the right orbital apex.
Findings:
- Surgical exploration identified a large vein compressing the optic nerve and superior orbital fissure nerves.
- The vein was dissected and removed via a frontotemporal extradural approach.
- Postoperatively, retro-ocular pain resolved, and ptosis improved, but visual acuity remained limited.
Implications:
- This case highlights orbital varix as a potential cause of orbital apex syndrome.
- Transcranial surgical intervention is effective for orbital varix causing nerve compression.
- Early diagnosis and surgical management are crucial for preserving visual function.