Bilateral ophthalmoplegia and exophthalmos complicating central hemodialysis catheter placement.
We describe a 58-year-old woman who presented with bilateral ophthalmoplegia, exophthalmos, and headache and was found to have retrograde internal jugular vein flow secondary to a high-grade obstruction of the ipsilateral brachiocephalic vein from a previous hemodialysis catheter placement. The patient had also a high-flow dialysis graft in the ipsilateral arm. The cranial and extracranial venous system congestion resolved, and the signs disappeared soon after a balloon angioplasty and stent placement at the level of the obstruction.
Varelas
P N
PN
Departments of Neurology and Radiology, Methodist Hospital Central, Memphis, TN, USA. Pvarelas@jHMI.edu
Bertorini
T E
TE
Halford
H
H
D000800:Angioplasty, Balloon; D016121:Brachiocephalic Veins / Q000601:surgery; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000150:complications; D005094:Exophthalmos / Q000209:etiology*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology*; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006435:Renal Dialysis