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Ischemic optic neuropathy associated with internal carotid artery dissection
V Biousse1, M Schaison, P J Touboul
1Department of Neurology, Hôpital Lariboisière, Paris, France. biousse@ccr.jussieu.fr
Archives of Neurology
|May 30, 1998
Summary
Ischemic optic neuropathy (ION) can be an early indicator of internal carotid artery dissection, particularly in younger individuals. Prompt investigation is crucial if ION presents with specific symptoms like pain or transient vision loss.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Surgery
Background:
- Ischemic optic neuropathy (ION) is optic nerve infarction typically caused by small artery disease.
- Carotid artery diseases, especially dissections, are rare causes of ION, with few cases previously reported.
Observation:
- This study details 4 cases of ION (2 anterior, 2 posterior) resulting from internal carotid artery dissection.
- These cases represented 3.6% of 110 patients with internal carotid artery dissection.
Findings:
- ION occurred a mean of 5.3 days after initial symptoms (headache, transient monocular blindness, or TIA).
- Associated symptoms included Horner syndrome (1 patient), severe headache/orbital pain (2 patients).
- No central retinal artery occlusion, ischemic ocular syndrome, or cerebral infarction was observed.
Implications:
- ION may serve as an early sign of internal carotid artery dissection.
- Suggestive features include young age, prior transient monocular blindness, pain, Horner syndrome, or TIA, warranting further investigation.