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Red-Rimmed Black Oval After-Effect of Cerebral Angiogram
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Red-Rimmed Black Oval After-Effect of Cerebral Angiogram

I experienced a cerebral hemorraghe in my right frontal lobe in June of this year. Over the next couple of days I was in the ICU and CAT scans, MRI/MRA, and angiogram were performed. Source/cause of bleed could not be determined and I was sent home. As a result a second MRI/MRA was performed again two months later. It came out normal. So a second angiogram was performed two weeks ago. It also came out normal.

I should mention that as a result of the hemorraghe I was very weak, experienced a seizure while in the ER, had no loss of any functions, but also have no recollection of anything happening (I just woke up in the ER wondering what had happened and why was I there). I was put on Dilantin as a precaution.

During the second angiogram two weeks ago, when the neurosurgeon was in the process of pumping the ink into my brain I saw a black oval rimmed in red in my right eye. I mentioned this to him after the angiogram and his reply was that most people see fireworks. My concern is that two weeks later I am still seeing the black oval rimmed in red, so I mentioned it at the followup visit with my neurologist. He said I probably had had a small stroke during the second angiogram and that is why they don't like to do them.

Since I continue to see the red-rimmed black oval I am concerned. I did not see it after the first angiogram in June, so know for sure that the first time I saw it was during the second angiogram two weeks ago. It is located tilted slightly off-center in my right eye at about eleven o'clock. I see it mostly when my right eye is closed, also when blinking, and there is an after image when I open my eye which disappears in about a second.

It is there about 90% of the time. It seems to be pressure-related somehow (i.e., if I rub my eye slightly or move quickly it immediately reappears). I sat still and watched it disappear one evening and the oval remained the same size, only the black portion got smaller until it was just a dot, and the red rim got larger until it filled in the entire oval. Then the redness dulled until you couldn't see it any more.

But the red-rimmed black oval keeps coming back and I am wondering what it is, how permanent it is, and if I should be concerned since it has now been two weeks after the angiogram and it is still there. Neither the neurosurgeon nor the neurologist seemed concerned when I mentioned it to them. What is this, how permanent is this, and does this indicate damage of some kind I should be concerned about and follow-up with an ophthalmologist. Something happened during the second angiogram and I would really like to know exactly what that was and what I should and can do about it. Thank you.
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Dear KC:

I am not really sure what to tell you.  I would think that a stroke would cause a field cut (loss of vision in a particular part of the visual field).  Since your visual abnormality is loss of a particular field (i.e. loss of a quandrant area of vision) then I must assume that it is in the visual cortex.  Since it is in the right eye then it must be in the left visual cortex.  Since the vision is such a constant with constant features it must be visual cortex.  But I am not sure what would cause a rimmed oval shape.  I would suggest that you might try seeing (please, this was not a pun) a neuro-opthalmologist.  Sorry, I am not sure.

Sincerely,

CCF Neuro MD
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