Brachiocephalic vein stenosis in association with ipsilateral hyperdynamic brachio-basilic fistula causing ipsilateral facial swelling and contralateral papillodema and visual loss. A case report.
A 69-year-old hypertensive woman with a hyperdynamic, left brachio-basilic dialysis fistula presented with a long history of throbbing in her head, swelling of the left side of the face and two months of right visual loss with gross swelling of the right optic disc. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalised after dilatation and stenting with resolution of the papillodema.
Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, UK. penny.eames@UHL-tr.nhs.uk
P
P
Eames
L
L
Senthil
A
A
Thomas
P
P
Riley
M A
MA
Burdon
D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D004487:Edema / Q000209:etiology* / Q000473:pathology; D005123:Eye / Q000098:blood supply; D005145:Face / Q000098:blood supply; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010211:Papilledema / Q000209:etiology* / Q000473:pathology; D010690:Phlebography; D014786:Vision Disorders / Q000209:etiology* / Q000473:pathology