Journal of the neurological sciences
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Letter Case Reports
A case of shunt responsive tremor due to normal pressure hydrocephalus.
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Case Reports
Central retinal artery occlusion with concomitant ipsilateral cerebral infarction after cosmetic facial injections.
We report 2 cases of central retinal artery occlusion with concomitant ipsilateral cerebral infarction after cosmetic facial injections and a literature review. The 2 patients were two healthy women, in which cosmetic facial injections with autologous fat and filler were performed, respectively. ⋯ Neuroimaging showed multifocal small infarctions in the ipsilateral frontal lobe with occlusion of the ophthalmic artery in case 1 and multiple infarctions in the ipsilateral anterior and middle cerebral artery territories with subsequent hemorrhagic transformation in case 2. Poor visual prognosis and neurological complications can occur in healthy adults undergoing cosmetic facial injection, and all patients should be informed of this risk before the procedure.
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Blood-brain-barrier dysfunction is well known to accompany hypertensive posterior reversible encephalopathy syndrome (PRES) and is considered as the culprit of vasogenic edema and cerebral hemorrhage observed as part of this syndrome. An 84-year-old female was admitted with a diagnosis of PRES in the setting of malignant hypertension. The clinical course was further complicated by ischemic stroke and seizures. ⋯ These findings suggestive of increased permeability were not only confined to the blood-brain-barrier, but also involved the blood-retina-barrier interface. Our observations suggest that pathologic conditions that disrupt the integrity of blood-brain-barrier might concomitantly affect retinal microcirculation, which highly resembles cerebral microcirculation both anatomically and functionally. Imaging modalities sensitive for detection of blood-brain-barrier dysfunction, such as contrast enhanced FLAIR, might be helpful in identifying these abnormalities.