The unnamed patient “had no history of head injury or loss of consciousness and he was taking no medications,” Dr Zia Carrim and two other physicians from Southern General Hospital said.
Body temperature and blood pressure were both normal and a neurological exam scanned negative. But when an eye specialist was called in, the fog began to clear.
The patient, said the ophthalmologist, had swollen optical discs, greatly enlarged blind spots and what eye doctors call “flame haemorrhages” or bleeding nerve fibres.
“We sought a more detailed history” from the patient, noted Dr Carrim.
That is when the man revealed he had consumed some 60 pints of beer over a four-day period, following a domestic crisis.
Severe dehydration, the doctors guessed, had led to a rare condition called cerebral venous sinus thrombosis (CVST).
A scan of the brain’s blood vessels confirmed the diagnosis. CVST — which can cause seizures, impaired consciousness and loss of vision - strikes three or four people per million every year in Britain.
It took more than six months of long-term blood-thinning treatment to restore the man’s normal vision — and to get rid of the headache, the doctors reported.