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--- transient_cortical_blindness [2025/06/30 21:30] – [Case reports] administrador
+++ transient_cortical_blindness [2025/06/30 21:32] (current) – administrador
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 Children may develop transient cortical blindness lasting 1-2 days , usually after a blow to the back of the [[head]].
-===== Case reports =====
-In a **Single-[[patient]] [[case report]]** detailing transient cortical blindness following [[pineal region meningioma surgery]]
-**Yip et al.**
-from the University of Edinburgh and NHS Lothian, Edinburgh, UK.
-published in *BMJ Case Reports*, **June 27, 2025**; Volume 18(6):e264865.
-to highlight the occurrence of **transient cortical blindness** following [[occipital lobe retraction]] during a pineal meningioma resection and raise awareness about anatomical risk factors.
-===== Key Clinical Course =====
-- Middle-aged woman with pineal meningioma causing triventriculomegaly.
-- Underwent ETV followed by tumor resection via **parieto-occipital interhemispheric approach**.
-- Post-op: **complete cortical blindness**, no MRI evidence of ischemia.
-- Gradual visual recovery: partial by 3 weeks, full by 8 months.
-- Implicated cause: **bilateral occipital retraction injury** despite uneventful surgery
-((Yip NZW, Barbour-Hastie C, Barron P, McKee JB, Kaliaperumal C. Transient cortical blindness following occipital lobe retraction in a pineal region meningioma resection. BMJ Case Rep. 2025 Jun 27;18(6):e264865. doi: 10.1136/bcr-2025-264865. PMID: 40579192.)).
-===== Critical Review =====
-- **Strengths**:
-  - Describes a rare but important surgical complication, especially relevant in posterior fossa and pineal surgery.
-  - Clear clinical timeline with good recovery documentation.
-  - Highlights subtleties of non-ischemic cortical dysfunction and relevance of fMRI in post-op assessment.
-- **Limitations**:
-  - Lack of **functional imaging** (e.g., fMRI, perfusion studies) to correlate with presumed retraction injury.
-  - No intraoperative monitoring data (e.g., visual evoked potentials) or detail on retraction technique.
-  - Tentorial angle mention is appropriate, but no imaging shown to support that anatomical claim.
-  - Single case, hence anecdotal and non-generalizable.
-===== Final Verdict =====
-- **Score**: 4.5/10 — educationally useful for neurosurgical awareness but limited by lack of objective neurophysiologic or imaging data.
-===== Takeaway for Neurosurgeons =====
-[[Occipital lobe retraction]]—even absent radiographic ischemia—can cause **reversible cortical blindness**, particularly in posterior approaches. Gentle retraction and patient selection (tentorial angle, age) may reduce risk.
-===== Bottom Line =====
-Transient cortical blindness may follow [[occipital lobe]] manipulation without infarction; full recovery is possible but underscores need for cautious occipital retraction during pineal region surgeries.
-===== Citation =====
-Transient cortical blindness following occipital lobe retraction in a pineal region meningioma resection.
-Yip NZW, et al. *BMJ Case Rep.* 2025;18(6):e264865. doi:10.1136/bcr-2025-264865.
-Corresponding author: Catriona Barbour-Hastie, catriona.barbour-hastie@nhs.scot