Amaurosis Fugax

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:

  • Diabetes
  • Heart disease
  • Smoking
  • Hypertension
  • Hyperlipidemia
  • Advanced age
  • Use of cocaine

Amaurosis fugax -Mechanism:

  • Thromboembolism from a carotid plaque
  • Hypoperfusion
  • Vasospasm
  • Elevated plasma viscosity, for example with leukemia, multiple myeloma
  • Atherosclerotic cerebrovascular disease

Hollenhorst plaque

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.

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