Blindness and visual field defects following cerebral angiography*

Abstract

Loss of vision following cerebral angiography is an uncommon but frightening complication. Eight patients who became cortically blind after carotid and vertebral angiography were reviewed in a Neuro-Ophthalmology clinic, and followed up for a period of up to two years. The onset of blindness in all the cases was immediately noticed when the patient awakened from anaesthesia and its duration ranged from two to 21 days. Full return of vision was the universal outcome.

The post-mortem examination on one of the cases is described and revealed the presence of several healing micro-infarcts in the striate cortex of the right occipital lobe. A search of the literature was made and possible explanations to account for cortical blindness after cerebral angiography are discussed. It is postulated that air micro-embolism was the cause of blindness in the patients reviewed and evidence from the literature considered. Detection of air micro-embolism during angiography is possible using ultrasound probes and it is hoped that this may lead to a greater awareness of air embolism as a possible cause of cortical blindness.