TY - JOUR
T1 - Intracranial hypertension associated with arthroprosthetic cobaltism?
AU - Hsu, Chia Wei
AU - Raviskanthan, Subahari
AU - Mortensen, Peter W.
AU - Lee, Andrew G.
N1 - Funding Information:
No funding or grant support
Publisher Copyright:
© 2022 The Authors
PY - 2022/3
Y1 - 2022/3
N2 - 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.
AB - 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.
KW - Increased intracranial hypertension
KW - Metal-on-metal articulations
KW - Systemic cobaltism
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U2 - 10.1016/j.ajoc.2022.101255
DO - 10.1016/j.ajoc.2022.101255
M3 - Article
AN - SCOPUS:85122510947
VL - 25
JO - Am J Ophthalmol Case Rep
JF - Am J Ophthalmol Case Rep
SN - 2451-9936
M1 - 101255
ER -