Cortical blindness following aortic arch surgery.
OBJECTIVE
To report a patient with Marfan's syndrome in whom cortical blindness occurred after planned circulatory arrest during aortic arch surgery.


METHODS
A 31-year-old man underwent aortic arch surgery because of an acute aortic dissection due to Marfan's syndrome. He noticed poor vision after surgery, although his pupillary reflexes and fundi appeared normal. Magnetic resonance imaging (MRI) and positron emission tomography (PET) were performed 2 years and 9 months after his operation.


RESULTS
The MRI revealed cortical atrophy in the occipital cortex, and PET scans with fluorodeoxy glucose revealed extreme glucose hypometabolism in the occipital cortex. The atrophy reflected cortical laminar necrosis that presumably occurred during the planned circulatory arrest to the brain during the surgery.


CONCLUSIONS
It is occasionally difficult to diagnose cortical blindness with MRI, especially at the acute stage. We could find significant hypometabolism of the occipital cortex using PET.
Suzuki
Y
Y
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan.
Kiyosawa
M
M
Mochizuki
M
M
Ishii
K
K
Senda
M
M
D000328:Adult; D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery; D001284:Atrophy; D019575:Blindness, Cortical / Q000175:diagnosis / Q000209:etiology*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008382:Marfan Syndrome / Q000150:complications; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D011183:Postoperative Complications; D014055:Tomography, Emission-Computed
D005947:Glucose