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确定急性左侧视力丧失的病因:临床难题

Identifying the Cause of Acute Left-Sided Visual Loss: A Clinical Dilemma.

作者信息

Damughatla Anirudh R, Milan-Ortiz Vanessa, Koleti Pragna, Milan-Ortiz Myrna M, Pasham Sudhir Reddy, Damughatla Abhishek R, Kamatham Saivaishnavi, Bazzy Kareem

机构信息

Department of Internal Medicine, Wayne State University & Detroit Medical Center, Detroit, MI, USA.

Department of Internal Medicine, John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA.

出版信息

J Med Cases. 2023 Jun;14(6):200-203. doi: 10.14740/jmc4093. Epub 2023 Jun 29.

Abstract

Given the global increase in the incidence of head and neck cancers over the last decade, the use of chemoradiation has also increased. It is well known that chemotherapy/radiation are established standard therapies in head and neck cancers, especially in patients who are not candidates for surgery. Despite this increase in chemoradiation therapies in head and neck cancers, there is a lack of established guidelines on the surveillance and screening of these patients for long-term complications. We present an interesting case of acute left eye blindness in a veteran patient with a history of laryngeal cancer status post chemoradiation and in the setting of a left ventricular (LV) thrombus on anticoagulation resulting in a diagnostic challenge determining the etiology. This case emphasizes the need for thorough patient-centered annual evaluation, thus providing an opportunity for early noninvasive or minimally invasive intervention.

摘要

鉴于过去十年全球头颈癌发病率上升,放化疗的使用也有所增加。众所周知,化疗/放疗是头颈癌的既定标准疗法,尤其是对于不适合手术的患者。尽管头颈癌放化疗治疗有所增加,但对于这些患者长期并发症的监测和筛查缺乏既定指南。我们报告了一例有趣的病例,一名有喉癌放化疗史的老年患者出现急性左眼失明,且在接受抗凝治疗的情况下存在左心室(LV)血栓,这给确定病因带来了诊断挑战。该病例强调了以患者为中心进行全面年度评估的必要性,从而为早期无创或微创干预提供机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60e2/10332869/b3134e1444be/jmc-14-200-g001.jpg

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