Intracranial hypertension associated with arthroprosthetic cobaltism?
Purpose: The purpose of this case report was to detail a unique patient with proven systemic cobaltism from metal-on-metal prosthetic hip articulation who then presented with clinical and radiographic signs of increased intracranial pressure. Observations: A 59-year-old man with a past medical histo...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622000019 |
| _version_ | 1831703712459915264 |
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| author | Chia Wei Hsu Subahari Raviskanthan Peter W. Mortensen Andrew G. Lee |
| author_facet | Chia Wei Hsu Subahari Raviskanthan Peter W. Mortensen Andrew G. Lee |
| author_sort | Chia Wei Hsu |
| collection | DOAJ |
| description | Purpose: The purpose of this case report was to detail a unique patient with proven systemic cobaltism from metal-on-metal prosthetic hip articulation who then presented with clinical and radiographic signs of increased intracranial pressure. Observations: A 59-year-old man with a past medical history of degenerative joint disease of the hip that status post total hip arthroplasty with cobalt-chromium implant presented with clinical and radiographic signs of increased intracranial hypertension. He underwent a revision arthroplasty with local debridement and removal of the cobalt-chromium implant and his serum cobalt level was elevated at 0.9 microg/L (normal range 0.1–0.4microg/L). One year after removal of the implant, the patient was asymptomatic and stable on acetazolamide. Conclusions: To our knowledge, this is the first such report in the English literature to associate increased intracranial hypertension with systemic cobaltism, and publication of this case report would make clinicians aware of the potential neurologic and neuro-ophthalmic presentation of metal-on-metal orthopedic prosthetics. |
| first_indexed | 2024-12-20T15:45:25Z |
| format | Article |
| id | doaj.art-011dabf7410e4314a13ce1d85664fa64 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-20T15:45:25Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-011dabf7410e4314a13ce1d85664fa642022-12-21T19:34:59ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-03-0125101255Intracranial hypertension associated with arthroprosthetic cobaltism?Chia Wei Hsu0Subahari Raviskanthan1Peter W. Mortensen2Andrew G. Lee3M.D.-Ph.D. Combined Degree Program, School of Medicine, University of Texas Medical Branch, Galveston, TX, USADepartment of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USADepartment of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USADepartment of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA; Texas A and M College of Medicine, Bryan, TX, USA; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA; Corresponding author. Department of Ophthalmology - Blanton Eye Institute Houston Methodist Hospital, 6560 Fannin St. Ste 450, Houston, TX, 77030, USAPurpose: The purpose of this case report was to detail a unique patient with proven systemic cobaltism from metal-on-metal prosthetic hip articulation who then presented with clinical and radiographic signs of increased intracranial pressure. Observations: A 59-year-old man with a past medical history of degenerative joint disease of the hip that status post total hip arthroplasty with cobalt-chromium implant presented with clinical and radiographic signs of increased intracranial hypertension. He underwent a revision arthroplasty with local debridement and removal of the cobalt-chromium implant and his serum cobalt level was elevated at 0.9 microg/L (normal range 0.1–0.4microg/L). One year after removal of the implant, the patient was asymptomatic and stable on acetazolamide. Conclusions: To our knowledge, this is the first such report in the English literature to associate increased intracranial hypertension with systemic cobaltism, and publication of this case report would make clinicians aware of the potential neurologic and neuro-ophthalmic presentation of metal-on-metal orthopedic prosthetics.http://www.sciencedirect.com/science/article/pii/S2451993622000019Increased intracranial hypertensionSystemic cobaltismMetal-on-metal articulations |
| spellingShingle | Chia Wei Hsu Subahari Raviskanthan Peter W. Mortensen Andrew G. Lee Intracranial hypertension associated with arthroprosthetic cobaltism? American Journal of Ophthalmology Case Reports Increased intracranial hypertension Systemic cobaltism Metal-on-metal articulations |
| title | Intracranial hypertension associated with arthroprosthetic cobaltism? |
| title_full | Intracranial hypertension associated with arthroprosthetic cobaltism? |
| title_fullStr | Intracranial hypertension associated with arthroprosthetic cobaltism? |
| title_full_unstemmed | Intracranial hypertension associated with arthroprosthetic cobaltism? |
| title_short | Intracranial hypertension associated with arthroprosthetic cobaltism? |
| title_sort | intracranial hypertension associated with arthroprosthetic cobaltism |
| topic | Increased intracranial hypertension Systemic cobaltism Metal-on-metal articulations |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622000019 |
| work_keys_str_mv | AT chiaweihsu intracranialhypertensionassociatedwitharthroprostheticcobaltism AT subahariraviskanthan intracranialhypertensionassociatedwitharthroprostheticcobaltism AT peterwmortensen intracranialhypertensionassociatedwitharthroprostheticcobaltism AT andrewglee intracranialhypertensionassociatedwitharthroprostheticcobaltism |