Transient visual loss
Amaurosis fugax is a harbinger of an imminent stroke.
Amaurosis fugax is a result of an occlusion or stenosis of the internal carotid artery circulation.
Risk factors for amaurosis fugax include:
- Heart disease
- Advanced age
- Use of cocaine
Amaurosis fugax -Mechanism:
- Thromboembolism from a carotid plaque
- Elevated plasma viscosity, for example with leukemia, multiple myeloma
- Atherosclerotic cerebrovascular disease
Retinal examination shows cholesterol plaque lodged within a retinal vessel called Hollenhorst plaque.
Carotid Doppler- assess the extracranial and intracranial status of the vessels.
Magnetic resonance angiography – Internal carotid artery evaluation
Computed tomography angiography – evaluate the patency of the internal carotid arteries.
ECG and Holter monitoring – To recognize arrhythmia and Source of emboli
Transesophageal echocardiography -should be obtained to rule out any possible source of rhythmic disturbance or cardiac emboli.