THE OPHTHALMOLOGY OF INTRACRANIAL VASCULAR ABNORMALITIES

PURPOSE: To provide a practical review of the ophthalmologic manifesta tions of intracranial vascular abnormalities, METHODS: We reviewed ocu lar manifestations of the most common intracranial vascular abnormalit ies: intracranial aneurysms, carotid-cavern ous fistulas, arteriovenou s malformations, and cavernous malformations, RESULTS: Unruptured aneu rysms can compress the third cranial nerve and the anterior visual pat hways,Ruptured aneurysms and subarachnoid hemorrhage can result in Ter son syndrome and papilledema, Direct and indirect carotid-cavern ous f istulas most commonly cause the classic triad of proptosis, conjunctiv al chemosis, and cranial bruit but can masquerade as chronic conjuncti vitis, Arteriovenous malformations, with or without hemorrhage, may co mpress portions of the retro chiasmal pathways, causing visual field l oss, Cavernous malformations, when in the brainstem, commonly cause ab normalities of supranuclear, nuclear, and fascicular ocular motility, CONCLUSIONS: The ophthalmologist may be the first physician to encount er clinical manifestations of intracranial vascular abnormalities that may herald devastating neurologic complications, Prompt diagnosis fac ilitates appropriate manage ment and therapy. (C) 1998 by Elsevier Sci ence Inc. All rights reserved.