동측 일과성 흑암시를 보인 내경동맥 무발생증
Amaurosis Fugax Associated with Ipsilateral Internal Carotid Artery Agenesis
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목적: 반복되는 일과성 흑암시를 보인 환자에서 동측 내경동맥 무발생을 진단하여 이를 보고하고자 한다. 증례요약: 50세 여자 환자가 좌안에 발생한 일과성 흑암시를 주소로 내원하였으며, 최근 빈도가 잦아져 1개월에 1회 정도로 반복되는 양상이었다. 과거력상 고혈압과 고지혈증을 진단 받고 약물치료 중이었다. 양안 나안시력은 20/20이었다. 세극등현미경검사에서 양안 모두 인공수정체안이었고 이외 특이소견은 없었다. 안저검사에서 근시성 안저와 근시성 경사유두가 관찰되었다. 형광안저혈관조영술 결과는 정상이었다. 전산화단층촬영검사에서 좌측 경동맥관이 관찰되지 않았고, 뇌자기공명혈관조영술에서 좌측 내경동맥이 보이지 않아 내경동맥 무발생으로 진단되었다. 이외의 신경학적검사와 혈액검사는 모두 정상이었다. 이후 일과성 흑암시는 저절로 소실되었으며 12개월 후까지도 증상의 재발은 없었다. 매우 드물지만 일과성 흑암시가 내경동맥의 발생이상과 연관될 수 있음을 보여주었다.
Abstract
Purpose: We report a case of amaurosis fugax associated with ipsilateral internal carotid artery agenesis. Case summary: A 50-year-old woman presented with amaurosis fugax in her left eye; the frequency of episodes of the condition had recently increased to once a month. She had a history of hypertension and dyslipidemia, and was under medical therapy. The visual acuity of both eyes was 20/20. Slit-lamp examination was normal except for pseudophakia. Ophthalmoscopy revealed a myopic tigroid fundus and a myopic tilted disc. No abnormalities were evident in fluorescein fundus angiography. Brain computed tomography showed that the left bony carotid canal was absent, and magnetic resonance angiography showed that the left internal carotid artery was also absent. She was diagnosed with left internal carotid artery agenesis. Other neurological and hematological parameters were within normal ranges. The amaurosis fugax spontaneously disappeared and has not recurred over the past 12 months. Our case, although rare, suggests that amaurosis fugax may be associated with internal carotid artery agenesis.
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