A 56 YEAR OLD MAN WITH TRANSIENT VISUAL LOSS

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Presentation transcript:

A 56 YEAR OLD MAN WITH TRANSIENT VISUAL LOSS Teaching NeuroImages Neurology Resident and Fellow Section © 2017 American Academy of Neurology

Vignette Five episodes of left eye visual loss Five-minute duration Curtain-like, moving in nasal-to-temporal direction Followed by left periorbital pulsatile headache Ictal fundus photography showed multiple vasoconstrictions of the central retinal artery/vein and their branches Rest of neurological exam normal © 2017 American Academy of Neurology El Youssef et al

Imaging El Youssef et al Ictal fundus photography showed multiple vasoconstrictions of the central retinal artery/vein and their branches (figure A), with resolution 10 minutes later (figure B) Fundus photography: ictal (A) and post-ictal (B) El Youssef et al © 2017 American Academy of Neurology

Retinal migraine in action Migraine pathophysiology is controversial Vasospasm remains a possible contributor/epiphenomenon in retinal migraine References: Kowacs PA, Utiumi MA, Piovesan EJ. The visual system in migraine: from the bench side to the office. Headache. 2015 Feb; 55 Suppl 1:84-98. El Youssef et al © 2017 American Academy of Neurology