Central nervous system vascular diseases in ophthalmology clinic_Chinese Journal of Ocular Fundus Diseases

Authors：

Gan Linyang ,  Zhong Yong

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China;

Corresponding author：

Zhong Yong, Email: yzhong_eye@163.com

Keywords：

Central nervous system diseases; Intracranial aneurysm; Carotid-cavernous sinus fistula; Intracranial hypertension; Review

DOI：

10.3760/cma.j.cn511434-20200303-00089

Video：

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Central nervous system vascular disease can be combined with a variety of ocular signs, such as orbital pain, flash, visual field defects, vision loss, eye muscle paralysis. Therefore, some patients were first diagnosed in ophthalmology, including aneurysm rupture, arterial dissection, cerebral apoplexy and other critical nervous system diseases that need rapid treatment. If the doctors didn't know enough, the diagnosis and treatment might be delayed. Most of the vascular diseases of the central nervous system related to ophthalmology have clinical manifestations that cannot be explained by ophthalmology. In the face of chronic conjunctivitis, unexplained visual field defect or cranial nerve paralysis with local ineffective treatment, it is necessary to broaden the thinking of differential diagnosis. To understand the characteristics of vascular diseases of the central nervous system that are prone to ocular manifestations can provide references for the clinical diagnosis and treatment of ophthalmology.

Citation： Gan Linyang, Zhong Yong. Central nervous system vascular diseases in ophthalmology clinic. Chinese Journal of Ocular Fundus Diseases, 2020, 36(4): 315-318. doi: 10.3760/cma.j.cn511434-20200303-00089 Copy

1.	Bozkurt MF, Dinc E, Eken E, et al. A rare cause of sudden ptosis: posterior communicating artery aneurysm[J]. Turk J Emerg Med, 2015, 15(2): 90-92. DOI: 10.5505/1304.7361.2015.90001.
2.	Durner G, Piano M, Lenga P, et al. Cranial nerve deficits in giant cavernous carotid aneurysms and their relation to aneurysm morphology and location[J]. Acta Neurochir (Wien), 2018, 160(8): 1653-1660. DOI: 1610.1007/s00701-00018-03580-00702.
3.	Buno BO 2nd, Cruz FM. Neuro-ophthalmological presentation of giant intracavernous carotid artery aneurysm in a child[J/OL]. BMJ Case Rep, 2018, 11(1): 225842[2018-11-28]. http://dx.doi.org/10.1136/bcr-2018-225842. DOI: 225810.221136/bcr-222018-225842.
4.	Koskela E, Setälä K, Kivisaari R, et al. Visual field findings after a ruptured intracranial aneurysm[J]. Acta Neurochir (Wien), 2014, 156(7): 1273-1279. DOI: 1210.1007/s00701-00014-02086-00709.
5.	Howard BM, Barrow DL. Neuro-ophthalmology and intracranial aneurysms[J]. World Neurosurg, 2015, 83(3): 291-293. DOI: 10.1016/j.wneu.2014.06.035.
6.	Ghorbani M, Hejazian SE, Dastmalchi A, et al. Orbital compartment syndrome secondary to direct carotid cavernous fistula after carotid cavernous aneurysm rupture: case report and review of literature[J]. World Neurosurg, 2020, 133: 409-412. DOI: 10.1016/j.wneu.2019.1008.1037.
7.	Burkhardt JK, Winkler EA, Lasker GF, et al. Isolated abducens nerve palsy associated with subarachnoid hemorrhage: a localizing sign of ruptured posterior inferior cerebellar artery aneurysms[J]. J Neurosurg, 2018, 128(6): 1830-1838. DOI: 1810.3171/2017.1832.JNS162951.
8.	Finger G, Martins OG, Nesi WM, et al. Ruptured aneurysm in the posterior communicating segment of carotid artery presenting with contralateral oculomotor nerve palsy[J]. Surg Neurol Int, 2019, 10: 177. DOI: 10.25259/SNI_25203_22019.
9.	Petridis AK, Kamp MA, Cornelius JF, et al. Aneurysmal Subarachnoid Hemorrhage[J]. Dtsch Arztebl Int, 2017, 114(13): 226-236. DOI: 10.3238/arztebl.2017.0226.
10.	马瑾, 张竹花, 赵潺, 等. 颈内动脉瘤致视功能损伤三例[J]. 中华眼科杂志, 2015, 51(6): 460-462. DOI: 10.3760/cma.j.issn.0412-4081.2015.06.016.Ma J, Zhang ZH, Zhao C, et al. Three cases of visual impairment caused by internal carotid aneurysm[J]. Chin J Ophthalmol, 2015, 51(6): 460-462. DOI: 10.3760/cma.j.issn.0412-4081.2015.06.016.
11.	Lang M, Habboub G, Mullin JP, et al. A brief history of carotid-cavernous fistula[J]. J Neurosurg, 2017, 126(6): 1995-2001. DOI: 10.3171/2016.5.JNS152372.
12.	Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management[J]. Eye (Lond), 2018, 32(2): 164-172. DOI: 10.1038/eye.2017.240.
13.	Canellas M, Cheema N. Misdiagnosed spontaneous carotid cavernous sinus fistula[J]. Clin Pract Cases Emerg Med, 2019, 3(3): 256-258. DOI: 10.5811/cpcem.2019.4.42247.
14.	English SW, Passe TJ, Lindell EP, et al. Multiple cranial neuropathies as a presentation of spontaneous internal carotid artery dissection: a case report and literature review[J]. J Clin Neurosci, 2018, 50: 129-131. DOI: 10.1016/j.jocn.2018.01.056.
15.	Lyrer PA, Brandt T, Metso TM, et al. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection[J]. Neurology, 2014, 82(18): 1653-1659. DOI: 10.1212/WNL.0000000000000381.
16.	Sánchez-de la Torre JR, Drake-Pérez M, Casado A, et al. Persistent isolated mydriasis as an early sign of internal carotid artery dissection: Pourfour du petit syndrome[J]. Clin Neurol Neurosurg, 2019, 182: 70-72. DOI: 10.1016/j.clineuro.2019.04.030.
17.	Cadena R. Cervical artery dissection: early recognition and stroke prevention[J]. Emerg Med Pract, 2016, 18(7): 1-24. DOI: 410.1097/ICU.0000000000000518.
18.	Madriz Peralta G, Cestari DM. An update of idiopathic intracranial hypertension[J]. Curr Opin Ophthalmol, 2018, 29(6): 495-502. DOI: 10.1097/ICU.0000000000000518.
19.	Wall M. Update on idiopathic intracranial hypertension[J]. Neurol Clin, 2017, 35(1): 45-57. DOI: 10.1016/j.ncl.2016.08.004.
20.	Smith SV, Friedman DI. The idiopathic intracranial hypertension treatment trial: a review of the outcomes[J]. Headache, 2017, 57(8): 1303-1310. DOI: 10.1111/head.13144.
21.	Burch RC, Buse DC, Lipton RB. Migraine:epidemiology, burden, and comorbidity[J]. Neurol Clin, 2019, 37(4): 631-649. DOI: 10.1016/j.ncl.2019.06.001.
22.	van Dongen RM, Haan J. Symptoms related to the visual system in migraine[J/OL]. F1000Res, 2019, 2019: E1[2019-07-30]. https://f1000research.com/articles/8-1219/v1. DOI:10.12688/f1000research.18768.1.[published online ahead of print].
23.	Puledda F, Ffytche D, O'Daly O, et al. Imaging the visual network in the migraine spectrum[J]. Front Neurol, 2019, 10: 1325. DOI: 10.3389/fneur.2019.01325.
24.	Shah DR, Dilwali S, Friedman DI. Migraine aura without headache[corrected][J]. Curr Pain Headache Rep, 2018, 22(11): 77. DOI: 10.1007/s11916-018-0725-1.
25.	Zengin Karahan S, Boz C, Saip S, et al. Susac syndrome: clinical characteristics, diagnostic findings and treatment in 19 cases[J]. Mult Scler Relat Disord, 2019, 33: 94-99. DOI: 10.1016/j.msard.2019.05.018.
26.	Seifert-Held T, Langner-Wegscheider BJ, Komposch M, et al. Susac's syndrome: clinical course and epidemiology in a Central European population[J]. Int J Neurosci, 2017, 127(9): 776-780. DOI: 710.1080/00207454.00202016.01254631.
27.	Vishnevskia-Dai V, Chapman J, Sheinfeld R, et al. Susac syndrome: clinical characteristics, clinical classification, and long-term prognosis[J]. Medicine (Baltimore), 2016, 95(43): 5223. DOI: 5210.1097/MD.0000000000005223.
28.	Dorr J, Krautwald S, Wildemann B, et al. Characteristics of Susac syndrome: a review of all reported cases[J]. Nat Rev Neurol, 2013, 9(6): 307-316. DOI: 310.1038/nrneurol.2013.1082.
29.	van der Kooij SM, van Buchem MA, Overbeek OM, et al. Susac syndrome: a report of four cases and a review of the literature[J]. Neth J Med, 2015, 73(1): 10-16.
30.	Heng LZ, Bailey C, Lee R, et al. A review and update on the ophthalmic implications of Susac syndrome[J]. Surv Ophthalmol, 2019, 64(4): 477-485. DOI: 10.1016/j.survophthal.2019.01.007.
31.	Trentadue M, Pozzi Mucelli R, Piovan E, et al. Incidental optochiasmatic cavernoma: case report of an unusual finding on 3 Tesla MRI[J]. Neuroradiol J, 2016, 29(4): 289-294. DOI: 210.1177/1971400916648335.
32.	Cerase A, Franceschini R, Battistini S, et al. Cavernous malformation of the optic nerve mimicking optic neuritis[J]. J Neuroophthalmol, 2010, 30(2): 126-131. DOI: 110.1097/WNO.1090b1013e3181ceb1428.
33.	Tan T, Tee JW, Trost N, et al. Anterior visual pathway cavernous malformations[J]. J Clin Neurosci, 2015, 22(2): 258-267. DOI: 210.1016/j.jocn.2014.1007.1027.
34.	Wolfe SQ, Manzano G, Langer DJ, et al. Cavernous malformation of the oculomotor nerve mimicking a partially thrombosed posterior communicating artery aneurysm: report of two cases[J]. Neurosurgery, 2011, 69(2): 470-474. DOI: 410.1227/NEU.1220b1013e31821cc31821f.
35.	Rotondo M, Natale M, D'Avanzo R, et al. Cavernous malformations isolated from cranial nerves: unexpected diagnosis?[J]. Clin Neurol Neurosurg, 2014, 126: 162-168. DOI: 10.1016/j.clineuro.2014.08.013.
36.	DelPino B, Durden J, Deshaies EM. Postoperative management of anterior visual pathway cavernoma, a unique perspective: case report[J]. Cureus, 2019, 11(1): 3819. DOI: 3810.7759/cureus.3819.
37.	Pula JH, Yuen CA. Eyes and stroke: the visual aspects of cerebrovascular disease[J]. Stroke Vasc Neurol, 2017, 2(4): 210-220. DOI: 10.1136/svn-2017-000079.
38.	Khandker N, Schmerler D, Mahajan S, et al. Value of eye movement examination in aiding precise localization in stroke[J]. Stroke, 2014, 45(8): 157-159. DOI: 10.1161/STROKEAHA.114.005754.
39.	Sugawara E, Nakamura H, Endo M, et al. Isolated unilateral ptosis due to paramedian midbrain infarction[J]. J Stroke Cerebrovasc Dis, 2015, 24(5): 121-123. DOI: 10.1016/j.jstrokecerebrovasdis.2015.01.027.
40.	Rowe FJ, VIS writing Group. Vision in stroke cohort: profile overview of visual impairment[J/OL]. Brain Behav, 2017, 7(11): 00771[2017-10-06]. https://onlinelibrary.wiley.com/doi/pdf/10.1002/brb3.771. DOI: 10.1002/brb3.771.
41.	Tamhankar MA, Biousse V, Ying GS, et al. Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study[J]. Ophthalmology, 2013, 120(11): 2264-2269. DOI: 10.1016/j.ophtha.2013.04.009.

1. Bozkurt MF, Dinc E, Eken E, et al. A rare cause of sudden ptosis: posterior communicating artery aneurysm[J]. Turk J Emerg Med, 2015, 15(2): 90-92. DOI: 10.5505/1304.7361.2015.90001.
2. Durner G, Piano M, Lenga P, et al. Cranial nerve deficits in giant cavernous carotid aneurysms and their relation to aneurysm morphology and location[J]. Acta Neurochir (Wien), 2018, 160(8): 1653-1660. DOI: 1610.1007/s00701-00018-03580-00702.
3. Buno BO 2nd, Cruz FM. Neuro-ophthalmological presentation of giant intracavernous carotid artery aneurysm in a child[J/OL]. BMJ Case Rep, 2018, 11(1): 225842[2018-11-28]. http://dx.doi.org/10.1136/bcr-2018-225842. DOI: 225810.221136/bcr-222018-225842.
4. Koskela E, Setälä K, Kivisaari R, et al. Visual field findings after a ruptured intracranial aneurysm[J]. Acta Neurochir (Wien), 2014, 156(7): 1273-1279. DOI: 1210.1007/s00701-00014-02086-00709.
5. Howard BM, Barrow DL. Neuro-ophthalmology and intracranial aneurysms[J]. World Neurosurg, 2015, 83(3): 291-293. DOI: 10.1016/j.wneu.2014.06.035.
6. Ghorbani M, Hejazian SE, Dastmalchi A, et al. Orbital compartment syndrome secondary to direct carotid cavernous fistula after carotid cavernous aneurysm rupture: case report and review of literature[J]. World Neurosurg, 2020, 133: 409-412. DOI: 10.1016/j.wneu.2019.1008.1037.
7. Burkhardt JK, Winkler EA, Lasker GF, et al. Isolated abducens nerve palsy associated with subarachnoid hemorrhage: a localizing sign of ruptured posterior inferior cerebellar artery aneurysms[J]. J Neurosurg, 2018, 128(6): 1830-1838. DOI: 1810.3171/2017.1832.JNS162951.
8. Finger G, Martins OG, Nesi WM, et al. Ruptured aneurysm in the posterior communicating segment of carotid artery presenting with contralateral oculomotor nerve palsy[J]. Surg Neurol Int, 2019, 10: 177. DOI: 10.25259/SNI_25203_22019.
9. Petridis AK, Kamp MA, Cornelius JF, et al. Aneurysmal Subarachnoid Hemorrhage[J]. Dtsch Arztebl Int, 2017, 114(13): 226-236. DOI: 10.3238/arztebl.2017.0226.
10. 马瑾, 张竹花, 赵潺, 等. 颈内动脉瘤致视功能损伤三例[J]. 中华眼科杂志, 2015, 51(6): 460-462. DOI: 10.3760/cma.j.issn.0412-4081.2015.06.016.Ma J, Zhang ZH, Zhao C, et al. Three cases of visual impairment caused by internal carotid aneurysm[J]. Chin J Ophthalmol, 2015, 51(6): 460-462. DOI: 10.3760/cma.j.issn.0412-4081.2015.06.016.
11. Lang M, Habboub G, Mullin JP, et al. A brief history of carotid-cavernous fistula[J]. J Neurosurg, 2017, 126(6): 1995-2001. DOI: 10.3171/2016.5.JNS152372.
12. Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management[J]. Eye (Lond), 2018, 32(2): 164-172. DOI: 10.1038/eye.2017.240.
13. Canellas M, Cheema N. Misdiagnosed spontaneous carotid cavernous sinus fistula[J]. Clin Pract Cases Emerg Med, 2019, 3(3): 256-258. DOI: 10.5811/cpcem.2019.4.42247.
14. English SW, Passe TJ, Lindell EP, et al. Multiple cranial neuropathies as a presentation of spontaneous internal carotid artery dissection: a case report and literature review[J]. J Clin Neurosci, 2018, 50: 129-131. DOI: 10.1016/j.jocn.2018.01.056.
15. Lyrer PA, Brandt T, Metso TM, et al. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection[J]. Neurology, 2014, 82(18): 1653-1659. DOI: 10.1212/WNL.0000000000000381.
16. Sánchez-de la Torre JR, Drake-Pérez M, Casado A, et al. Persistent isolated mydriasis as an early sign of internal carotid artery dissection: Pourfour du petit syndrome[J]. Clin Neurol Neurosurg, 2019, 182: 70-72. DOI: 10.1016/j.clineuro.2019.04.030.
17. Cadena R. Cervical artery dissection: early recognition and stroke prevention[J]. Emerg Med Pract, 2016, 18(7): 1-24. DOI: 410.1097/ICU.0000000000000518.
18. Madriz Peralta G, Cestari DM. An update of idiopathic intracranial hypertension[J]. Curr Opin Ophthalmol, 2018, 29(6): 495-502. DOI: 10.1097/ICU.0000000000000518.
19. Wall M. Update on idiopathic intracranial hypertension[J]. Neurol Clin, 2017, 35(1): 45-57. DOI: 10.1016/j.ncl.2016.08.004.
20. Smith SV, Friedman DI. The idiopathic intracranial hypertension treatment trial: a review of the outcomes[J]. Headache, 2017, 57(8): 1303-1310. DOI: 10.1111/head.13144.
21. Burch RC, Buse DC, Lipton RB. Migraine:epidemiology, burden, and comorbidity[J]. Neurol Clin, 2019, 37(4): 631-649. DOI: 10.1016/j.ncl.2019.06.001.
22. van Dongen RM, Haan J. Symptoms related to the visual system in migraine[J/OL]. F1000Res, 2019, 2019: E1[2019-07-30]. https://f1000research.com/articles/8-1219/v1. DOI:10.12688/f1000research.18768.1.[published online ahead of print].
23. Puledda F, Ffytche D, O'Daly O, et al. Imaging the visual network in the migraine spectrum[J]. Front Neurol, 2019, 10: 1325. DOI: 10.3389/fneur.2019.01325.
24. Shah DR, Dilwali S, Friedman DI. Migraine aura without headache[corrected][J]. Curr Pain Headache Rep, 2018, 22(11): 77. DOI: 10.1007/s11916-018-0725-1.
25. Zengin Karahan S, Boz C, Saip S, et al. Susac syndrome: clinical characteristics, diagnostic findings and treatment in 19 cases[J]. Mult Scler Relat Disord, 2019, 33: 94-99. DOI: 10.1016/j.msard.2019.05.018.
26. Seifert-Held T, Langner-Wegscheider BJ, Komposch M, et al. Susac's syndrome: clinical course and epidemiology in a Central European population[J]. Int J Neurosci, 2017, 127(9): 776-780. DOI: 710.1080/00207454.00202016.01254631.
27. Vishnevskia-Dai V, Chapman J, Sheinfeld R, et al. Susac syndrome: clinical characteristics, clinical classification, and long-term prognosis[J]. Medicine (Baltimore), 2016, 95(43): 5223. DOI: 5210.1097/MD.0000000000005223.
28. Dorr J, Krautwald S, Wildemann B, et al. Characteristics of Susac syndrome: a review of all reported cases[J]. Nat Rev Neurol, 2013, 9(6): 307-316. DOI: 310.1038/nrneurol.2013.1082.
29. van der Kooij SM, van Buchem MA, Overbeek OM, et al. Susac syndrome: a report of four cases and a review of the literature[J]. Neth J Med, 2015, 73(1): 10-16.
30. Heng LZ, Bailey C, Lee R, et al. A review and update on the ophthalmic implications of Susac syndrome[J]. Surv Ophthalmol, 2019, 64(4): 477-485. DOI: 10.1016/j.survophthal.2019.01.007.
31. Trentadue M, Pozzi Mucelli R, Piovan E, et al. Incidental optochiasmatic cavernoma: case report of an unusual finding on 3 Tesla MRI[J]. Neuroradiol J, 2016, 29(4): 289-294. DOI: 210.1177/1971400916648335.
32. Cerase A, Franceschini R, Battistini S, et al. Cavernous malformation of the optic nerve mimicking optic neuritis[J]. J Neuroophthalmol, 2010, 30(2): 126-131. DOI: 110.1097/WNO.1090b1013e3181ceb1428.
33. Tan T, Tee JW, Trost N, et al. Anterior visual pathway cavernous malformations[J]. J Clin Neurosci, 2015, 22(2): 258-267. DOI: 210.1016/j.jocn.2014.1007.1027.
34. Wolfe SQ, Manzano G, Langer DJ, et al. Cavernous malformation of the oculomotor nerve mimicking a partially thrombosed posterior communicating artery aneurysm: report of two cases[J]. Neurosurgery, 2011, 69(2): 470-474. DOI: 410.1227/NEU.1220b1013e31821cc31821f.
35. Rotondo M, Natale M, D'Avanzo R, et al. Cavernous malformations isolated from cranial nerves: unexpected diagnosis?[J]. Clin Neurol Neurosurg, 2014, 126: 162-168. DOI: 10.1016/j.clineuro.2014.08.013.
36. DelPino B, Durden J, Deshaies EM. Postoperative management of anterior visual pathway cavernoma, a unique perspective: case report[J]. Cureus, 2019, 11(1): 3819. DOI: 3810.7759/cureus.3819.
37. Pula JH, Yuen CA. Eyes and stroke: the visual aspects of cerebrovascular disease[J]. Stroke Vasc Neurol, 2017, 2(4): 210-220. DOI: 10.1136/svn-2017-000079.
38. Khandker N, Schmerler D, Mahajan S, et al. Value of eye movement examination in aiding precise localization in stroke[J]. Stroke, 2014, 45(8): 157-159. DOI: 10.1161/STROKEAHA.114.005754.
39. Sugawara E, Nakamura H, Endo M, et al. Isolated unilateral ptosis due to paramedian midbrain infarction[J]. J Stroke Cerebrovasc Dis, 2015, 24(5): 121-123. DOI: 10.1016/j.jstrokecerebrovasdis.2015.01.027.
40. Rowe FJ, VIS writing Group. Vision in stroke cohort: profile overview of visual impairment[J/OL]. Brain Behav, 2017, 7(11): 00771[2017-10-06]. https://onlinelibrary.wiley.com/doi/pdf/10.1002/brb3.771. DOI: 10.1002/brb3.771.
41. Tamhankar MA, Biousse V, Ying GS, et al. Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study[J]. Ophthalmology, 2013, 120(11): 2264-2269. DOI: 10.1016/j.ophtha.2013.04.009.

Chinese Journal of Ocular Fundus Diseases

Central nervous system vascular diseases in ophthalmology clinic

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