From the Humanitas University (A.A., N.B., E.C.); IRCCS Humanitas Research Hospital (S.M.L., D.A., S.M., U.P.), Milan; Università dell'Insubria (N.B.), Varese, Italy.
Neurology. 2023 Jul 18;101(3):e336-e342. doi: 10.1212/WNL.0000000000207167. Epub 2023 Mar 1.
We report the case of a middle-aged man who presented with acute painless monocular vision loss. His medical history was remarkable for chronic total occlusion of the ipsilateral internal carotid artery (ICA) and a recent carotid endarterectomy (CEA) on the contralateral ICA. In a stepwise multidisciplinary approach assessment, we review the differential diagnosis of acute vision loss and investigate how the patient's intracranial and extracranial hemodynamic reorganization after chronic ICA occlusion may affect the clinical reasoning. Early complications of CEA and the differential diagnosis of new-onset anisocoria are also discussed.
我们报告了一例中年男性，他因急性无痛性单眼视力丧失而就诊。他的病史包括同侧颈内动脉（ICA）慢性完全闭塞和近期对侧 ICA 颈动脉内膜切除术（CEA）。在逐步的多学科评估中，我们回顾了急性视力丧失的鉴别诊断，并探讨了慢性 ICA 闭塞后患者颅内和颅外血液动力学重建如何影响临床推理。还讨论了 CEA 的早期并发症和新发性瞳孔不等大的鉴别诊断。
