Cerebral vasospasm and ischemia after orbital decompression for graves ophthalmopathy

Ophthalmic Plastic and Reconstructive Surgery
Chad D McCormickRichard L Anderson

Abstract

We describe the first reported cases of cerebral vasospasm, ischemia, and infarct after orbital decompression surgery for Graves disease-related ophthalmopathy. We present two patients who had inadvertent penetration of the dura mater during orbital decompression surgery. One case was recognized at surgery; the other was not. All patient data were gathered and relayed in accordance with state and U.S. laws. Postoperative cerebrospinal fluid leak, radiographic evidence of subarachnoid hemorrhage, and severe neurologic morbidity occurred in each case. Cerebral ischemia and infarction resulting from subarachnoid hemorrhage-induced cerebral vasospasm occurred in each case. The risk of dural penetration, cerebral vasospasm, and ischemia should be considered during preoperative evaluation for orbital decompression surgery. The diagnosis, treatment, and prevention of this previously unreported serious complication of this procedure is paramount.

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Citations

Mar 18, 2008·Thyroid : Official Journal of the American Thyroid Association·Luigi BartalenaWilmar M Wiersinga
Oct 11, 2005·Otolaryngologic Clinics of North America·Cat Nguyen Burkat, Bradley N Lemke
Oct 1, 2011·Orbit·Madeleine SchabergJurij R Bilyk
May 4, 2012·Orbit·L Fernando Gonzalez, Jurij R Bilyk
Aug 2, 2007·Ophthalmic Plastic and Reconstructive Surgery·Mohsen Bahmani KashkouliBehrooz Zaman
Jan 18, 2018·Ophthalmic Plastic and Reconstructive Surgery·Liza M CohenMichael K Yoon
Nov 24, 2005·Ophthalmic Plastic and Reconstructive Surgery·Bobby S Korn, Don O Kikkawa
Jul 12, 2011·Ophthalmic Plastic and Reconstructive Surgery·Ann P MurchisonJurij R Bilyk
Apr 17, 2008·Orbit·Jaime Badilla, Peter J Dolman
Sep 2, 2017·Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society·Eman Al-Sharif, Adel H Alsuhaibani
Jun 2, 2021·Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale·Claudio ParrillaEmanuele Scarano

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