CC BY 4.0 · Surg J (N Y) 2016; 02(01): e14-e16
DOI: 10.1055/s-0036-1571440
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Incidental Transient Cortical Blindness after Lung Resection

Murat Oncel
1   Department of Thoracic Surgery, Selcuk University Medical School, Konya, Turkey
,
Guven Sadi Sunam
1   Department of Thoracic Surgery, Selcuk University Medical School, Konya, Turkey
,
Asuman Orhan Varoglu
2   Department of Neurology, Selcuk University Medical School, Konya, Turkey
,
Hakan Karabagli
3   Department of Neurosurgery, Selcuk University Medical School, Konya, Turkey
,
Huseyin Yildiran
1   Department of Thoracic Surgery, Selcuk University Medical School, Konya, Turkey
› Author Affiliations
Further Information

Publication History

15 June 2015

18 December 2015

Publication Date:
04 February 2016 (online)

Abstract

Transient vision loss after major surgical procedures is a rare clinical complication. The most common etiologies are cardiac, spinal, head, and neck surgeries. There has been no report on vision loss after lung resection. A 65-year-old man was admitted to our clinic with lung cancer. Resection was performed using right upper lobectomy with no complications. Cortical blindness developed 12 hours later in the postoperative period. Results from magnetic resonance imaging and diffusion-weighted investigations were normal. The neurologic examination was normal. The blood glucose level was 92 mg/dL and blood gas analysis showed a PO2 of 82 mm Hg. After 24 hours, the patient began to see and could count fingers, and his vision was fully restored within 72 hours after this point. Autonomic dysfunction due to impaired microvascular structures in diabetes mellitus may induce posterior circulation dysfunction, even when the hemodynamic state is normal in the perioperative period. The physician must keep in mind that vision loss may occur after lung resection due to autonomic dysfunction, especially in older patients with diabetes mellitus.

 
  • References

  • 1 Williams EL. Postoperative blindness. Anesthesiol Clin North America 2002; 20 (03) 605-622
  • 2 Corso CM, Tanaka PP, Khon K. [Optic nerve ischemia after spine surgery: case report]. Rev Bras Anestesiol 2006; 56 (03) 273-277
  • 3 Kühn AL, Huch B, Wendt G, Dooms G, Droste DW. First description of posterior reversible encephalopathy syndrome as a complication of glycerolnitrate patch following open cardiac surgery. Acta Neurol Scand 2011; 124 (03) 218-220
  • 4 Tasdemir K, Evereklioglu C, Kaya MG. Transient cortical blindness and successful recovery after coronary bypass surgery. Acta Cardiol 2011; 66 (05) 661-664
  • 5 Kunishige T, Omori A, Tateno A, Yahata N, Hori J. Cortical blindness caused by hypoxemia following an asthma attack. Jpn J Ophthalmol 2011; 55 (05) 588-590
  • 6 Bandyopadhyay S, Mondal KK, Das S. , et al. Reversible cortical blindness: posterior reversible encephalopathy syndrome. J Indian Med Assoc 2010; 108 (11) 778-780
  • 7 Ho VT, Newman NJ, Song S, Ksiazek S, Roth S. Ischemic optic neuropathy following spine surgery. J Neurosurg Anesthesiol 2005; 17 (01) 38-44
  • 8 Verma R, Junewar V, Praharaj HN. Unusual association of eclamptic encephalopathy and Japanese encephalitis. BMJ Case Rep 2012; 2012: xx
  • 9 Akhtar N, Khatri IA, Naseer A, Ikram J, Ahmed W. Transient cortical blindness after coronary angiography: a case report and literature review. J Pak Med Assoc 2011; 61 (03) 295-297
  • 10 Fuchigami T, Inamo Y, Hashimoto K. , et al. Henoch-schönlein purpura complicated by reversible posterior leukoencephalopathy syndrome. Pediatr Emerg Care 2010; 26 (08) 583-585
  • 11 Oakley I, Emond L. Diabetic cardiac autonomic neuropathy and anesthetic management: review of the literature. AANA J 2011; 79 (06) 473-479
  • 12 Unger J. Uncovering undetected hypoglycemic events. Diabetes Metab Syndr Obes 2012; 5: 57-74