Out of Focus

INCOMPLETE CASE: RETURN LATER

History: A 49-year-old male with no past medical history comes to the ED because vision went out of focus for about 20 minutes before returning to normal.  It affected both eyes, which he checked independently. He did not have any double vision or vision going black or dark it was just out of focus for the entire time. About 10 minutes into this he developed a gradual onset mild right-sided headache which is now resolved as well. He denies any change in speech, balance, strength, coordination or other symptoms.

Exam: Normal

Initial Concern(s): TIA, Atypical Migraine

Testing: MR brain

Question(s): What does the MRI show? What can cause this?

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ANSWER(S): Arteriovenous malformation in the left cerebellum

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AVM’s from QUICK ESSENTIALS: Emergency Medicine 1-minute consult pocketbook

Clinical: Can p/w HA, Sz, TIA, CVA, SAH or ICB.

Treatment: Consult: embolize > surgery

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