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Valsalva-Induced Subperiorbital Hemorrhage During Migraine
Arch Ophthalmol. 1998;116:106-107.
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Common causes of orbital hemorrhage include trauma, surgery, vascular anomalies, tumors, and blood dyscrasias. Subperiorbital (subperiosteal) hemorrhage is less frequent. This entity has been reported rarely in healthy individuals after forceful Valsalva maneuver.1-3 We describe a 37-year-old man who suffered subperiorbital hemorrhage after an episode of migraine-associated emesis.
Report of a Case
A 37-year-old white man with a medical history remarkable only for migraine headaches was seen 2 days after a typical migraine episode that included nausea and emesis. Immediately following emesis, the patient noted diplopia, decreased visual acuity of the left eye, pain with eye movement, and fullness about the left orbit.
Best-corrected visual acuity was 20/20 OU. Confrontation visual fields and pupillary responses were normal. Pain occurred with versions in all directions. Trace limitation of left supraduction and 6 prism diopters (PD) of right hypertropia were observed. Mild left upper eyelid edema and ecchymosis were present (Figure 1). Palpebral fissure . . . [Full Text of this Article]
Comment
Corresponding author: Matthew M. Boyer, MD, Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, 600 Highland Ave, Dept F4/3, Madison, WI 53792-3220.
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ABSTRACT
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