[Sudden loss of vision as the result of the decompression after the removal of the arachnoid cyst of the temporal region. A case report].
BACKGROUND
The neurosurgical treatment of arachnoid cyst consist in evacuation of the cyst and in consequence the decrease of the endocranial pressure. From the neurosurgical point of view, both the endocranial hypertension and the sudden hypotension inside a skull after a surgical motion are very dangerous. The sudden loss of vision is the most adverse surgical complication for the patient. The aim of the work is the presentation of the child, who suddenly and completely lost the sight after performing a neurosurgical evacuation of the cyst of the arachnoidea.


METHODS
We introduce 6-year-old boy, who went blind after executed puncture of the arachnoidea cyst of temporal region of the brain. The dramatic, sudden lack of the feeling of light perception that lasted for about 2 weeks caused confusion and anxiety of the child. The vision slowly began to come back as time goes by, at first light perception recovered in one eye, and only after several months in the second eye too. Ptosis of one of the eyelid subided entirely. We observed the diminution of the squint angle, which appeared after the surgical intervention, as the result of applied treatment too.


CONCLUSIONS
The mechanism of the origin of this occurrence has not been fully identified, most likely it comes into being as a result of disturbances in the microcirculation of the optical nerve and the chiasma optical. The boy has been treated three times with Trental during the first year. After eight months from the incident of loss of vision, the acuity vision in right eye was 1/50 and 0.2 in left eye. We applied the intensive treatment of amblyopia and squint according to Szczecin's school of the strabismus treatment. The child obtained the improvement of the eyesight in the right eye to 0.1 and in the left eye to 0.9 (according to Snellen test).


CONCLUSIONS
The operative treatment of the arachnoidea cyst is an efficient conduct, though, at times complications happen which make the result of the treatment worse.
Puchalska-Niedbał
Lidia
L
Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72, 70-111 Szczecin.
Jezewski
Dariusz
D
D016080:Arachnoid Cysts / Q000601:surgery*; D001766:Blindness / Q000209:etiology*; D002648:Child; D019299:Decompression, Surgical / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012075:Remission, Spontaneous; D013702:Temporal Lobe