摘要:

BackgroundA young woman with a history of controlled hypertension noted a suddenly decreased peripheral temporal field in the left eye. This occurred after moderate peripartum hypertension.MethodA monocular peripheral temporal crescentic defect could be plotted on Goldmann visual fields despite a normal dilated peripheral retinal examination and normal disc appearance.ResultA dilated parieto-occipital sulcus could be seen on computed tomography, and magnetic resonance imaging showed changes consistent with atrophy and gliosis in the cuneus, precuneus, and anterior calcarine cortex surrounding the parieto-occipital sulcus.ConclusionBy magnetic resonance imaging, this can be seen to comprise less than 10% of the visual cortex, as suggested by the Horton and Hoyt revised Holmes map. The temporal crescent syndrome is a rare monocular retrochiasmatic visual field defect that can be correlated to a lesion along the parieto-occipital sulcus.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Takayasu's disease is an arteritis with a predilection for the proximal branches of the aortic arch. Chronic retinal hypoxic changes and ischemic ocular inflammation, resulting from cervical vascular occlusion, have been described extensively. Anterior ischemic optic neuropathy has rarely been reported in this condition, and only in conjunction with other ophthalmic findings. Here we present the case of a patient who developed bilateral anterior ischemic optic neuropathy in the absence of other eye findings, and was subsequently found to have an aortic arch syndrome compatible with Takayasu's disease.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Nonarteritic anterior ischemic optic neuropathy (AION) is a well-described entity that is believed to be caused by abnormal anatomy of the optic disc and to be precipitated by several stressor-s or disease states. Activated protein C resistance (APCR) is a recently described mutation of factor V (FV) gene that renders FV resistant to cleavage by activated protein C. APCR predisposes to thrombotic events. The case of a 61-year-old woman with AION and activated protein C resistance is presented, and the management is discussed. We thoroughly review the literature on these two conditions. We propose that a prospective analysis of the potential role of APCR in some cases of AION is needed and suggest that physicians consider this and other prothombotic states when evaluating patients with AION.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Bilateral diffuse uveal melanocytic proliferation is a rare paraneoplastic syndrome that causes visual loss in patients with systemic carcinoma. We report the case of a patient with this syndrome whose initial presentation and striking anterior segment findings mimicked that of an arteriovenous fistula.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Cutaneous carcinomas of the face, and some nasopharyngeal carcinomas, may present with facial dysesthesias and/or facial nerve palsies in the absence of visible masses. Even with frank ophthalmoplegia, occult tumors that present in this matter may elude detection, for which reason specific diagnostic studies must be employed. We report seven cases of trigeminal nerve infiltration by occult tumors (five squamous cell carcinomas, one basal cell carinoma, and one adenoid cystic carcinoma), and outline the clinical course, diagnostic investigations, and the subsequent management of these patients. The importance of establishing an early diagnosis before the tumor has transgressed the basal foramina is emphasized, as tumor infiltration of the cavernous sinus carries a more guarded prognosis. The use of magnetic resonance imaging to identify involved peripheral nerve branches that may then be biopsied is suggested. The patho-physiological mechanisms of neurotropic spread of tumor are reviewed.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A 66-year-old woman with a history of non-insulin-dependent diabetes mellitus, hypertension, and hypothy-roidism presented with a painless orbital apex syndrome without any sign of orbital cellulitis or acute systemic disease. Her blood glucose was mildly elevated, but there was no diabetic ketoacidosis. Neuroimaging revealed only mild sinus disease. Transnasal sphenoidal mucosal biopsy showed an inflammatory mass with cellular atypia on frozen sections, suggesting squamous cell carcinoma. However, review of the permanent sections showed broad, nonseptate hyphae consistent with mucormycosis. The patient was treated with a 3-month course of intravenous amphotericin B and no further surgery. Examination 3 months after presentation revealed complete resolution of her ocular motility deficits and partial resolution of her optic neuropathy. Mucormycosis should be suspected in any case of orbital apex syndrome, especially in the diabetic patient.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Intracranial adenoid cystic carcinoma is uncommon. We report two unusual cases of intracranial adenoid cystic carcinoma. The first patient presented with a steroid-responsive optic neuropathy from an orbital mass that simulated orbital pseudotumor, and subsequently developed intracranial involvement, presumably by contiguous perineural spread. The second patient presented with proptosis of the left eye, right facial weakness and numbness, and an intracranial mass, presumably from hematogenous metastatic spread.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Acquired supranuclear ocular motor paresis is a rare disorder characterized by impaired saccadic and smooth pursuit eye movements in one or more directions of gaze. Vestibularly induced eye movements, however, are preserved. Six adult patients developed an acquired supranuclear ocular motor paresis following cardiopulmonary bypass surgery. Neuroimaging studies were normal in two patients and were consistent with small vessel ischemia in four patients. The mean cardiopulmonary bypass time was 132.3 min, and mean circulatory arrest time was 38.7 min; these were not outside established norms for this type of surgery. Patients undergoing cardiopulmonary bypass precedures with deep hypothermia are at risk for acquired supranuclear ocular motor paresis, but the development of this syndrome may not be predictable by duration of circulatory arrest or cardiopulmonary bypass times.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Despite advances in neurosurgery, radiation oncology, and chemotherapy, the prognosis for glioblastoma multiforme remains poor, with a median survival time of 11–12 months. Cisplatin (cis-diamminedichlorideplatinum II) is one treatment for glioblastoma multiforme. Higher response rates have been achieved by intraarterial (IA) infusion than by systemic infusion of this agent. Cisplatin therapy may cause neurologic complications, and IA delivery has been reported to cause ocular toxicity. We report a patient who experienced intraorbital and intraocular toxicity following supraophthalmic IA injection of cisplatin.

ISSN:1070-8022    

出版商:OVID    

年代:1997

数据来源: OVID