Transient cortical blindness after intradiscal oxygen-ozone therapy

Abstract

A 54-year-old caucasian male developed bilateral blindness during an oxygen-ozone injection for disc herniation. The visual loss (VL) was immediately followed by severe frontal headache, vomiting, and nausea. The patient underestimated the VL showing Anton's syndrome, with a complete visual recovery after 2-month follow-up. Magnetic resonance data were consistent with recent ischemic lesions in bilateral vascular territories of posterior cerebral arteries.

Figure 1

(a and b) Magnetic resonance imaging: diffusion-weighted imaging (on the left) and corresponding apparent diffusion coefficients map (on the right). Hyperintensity in diffusion-weighted imaging and hypointensity in apparent diffusion coefficient map can be seen in the occipito-parietal cortex bilaterally, with a significant larger extension on the right side (a) and also in the right medial thalamus (b). (c) Fluid-attenuated inversion recovery magnetic resonance imaging confirms asymmetrical, mainly on the right side, ischemic lesion showing bilaterally high signal intensity areas in the occipito-parietal cortex

Figure 2

After 4 months: Diffusion-weighted imaging (on the left) and corresponding apparent diffusion coefficient map (in the middle) magnetic resonance imaging show size reduction of the hyperintensities compared to the same sequences of the affected areas. Fluid-attenuated inversion recovery (on the right) suggests both resorption of the vasogenic edema and signs of poststroke gliosis