title: A Case of Complete Recovery of Fluctuating Monocular Blindness Following Endovascular Treatment in Internal Carotid Artery Dissection.
abstract: BACKGROUND
  Monocular blindness may appear as the first symptom of internal carotid artery dissection (ICAD). However, there have been no reports that monocular visual loss repeatedly occurs and disappears in response to postural change in ICAD.
  
  
  METHODS
  A 33-year-old woman presented with transient monocular blindness (TMB) following acute-onset headache. TMB repeatedly occurred in response to postural change. Two days later, she experienced transient dysarthria and right hemiparesis in upright position. Pupil size and light reflex were normal, but a relative afferent pupillary defect was positive in the left eye. Diffusion-weighted imaging showed no acute lesion, but perfusion-weighted imaging showed perfusion delay in the left ICA territory. Digital subtraction angiography demonstrated a false lumen and an intraluminal filling defect in proximal segment of the left ICA.
  
  
  RESULTS
  Carotid stenting was performed urgently. After carotid stenting, left relative afferent pupillary defect disappeared and TMB was not provoked anymore by upright posture. At discharge, left visual acuity was completely normalized.
  
  
  CONCLUSIONS
  Because fluctuating visual symptoms in the ICAD may be associated with hemodynamically unstable status, assessment of the perfusion status should be done quickly. Carotid stenting may be helpful to improve the fluctuating visual symptoms and hemodynamically unstable status in selected patient with the ICAD.
authors.affiliation: Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Ki-Tae
authors.initials: KT
authors.lastname: Kim
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Seung Guk
authors.initials: SG
authors.lastname: Baik
authors.affiliation: Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Kyung-Pil
authors.initials: KP
authors.lastname: Park
authors.affiliation: Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea. Electronic address: umbilicus2@gmail.com.
authors.forename: Min-Gyu
authors.initials: MG
authors.lastname: Park
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D001766:Blindness / Q000209:etiology*; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D020127:Recovery of Function / Q000502:physiology*
keywords: Transient monocular blindness; dissection; internal carotid artery; stenting