摘要:

We report a patient with a third nerve palsy and contra-lateral eyelid retraction from a thalamic-midbrain infarction. Magnetic resonance imaging confirms that this unusual clinical combination, previously termed “the plus-minus lid syndrome,” results from a lesion in the region of the nucleus of the posterior commissure with extension to the third nerve fascicle.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Blows to the forehead resulted in orbital roof fractures and subfrontal epidural hemorrhage in three patients. Neurologic eye signs were limited to ipsilateral paralysis of globe and lid elevation. In the context of an ecchymotic upper lid, these findings indicate local damage to orbital muscles rather than injury to the superior division of the third nerve. Even when such patients are alert, prompt computed tomographic (CT) scanning of the head should be undertaken to rule out an enlarging epidural hematoma.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We report one case with isolated unilateral superior branch oculomotor nerve palsy due to an erosive sphenoid sinusitis. Within 8 weeks after surgical drainage of the sphenoid sinusitis, the patient recovered fully from the superior branch oculomotor palsy. In view of the dramatic clinical improvement that followed surgery, we hypothesized a compression of the superior branch of the oculomotor nerve by the sphenoidal abscess. To our knowledge, this is the first reported case of a superior branch oculomotor nerve palsy related to an erosive sinusitis and cured by sinusotomy, a safe and simple surgical procedure. Thus, we believe that our observation bears some practical implications of clinical importance in the management of patients who present partial oculomotor nerve palsy.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A 42-year-old man suffered from acute evolving visual loss after drinking alcohol. Consecutive visual field changes suggested a mass within the left optic nerve extending its compression across the chiasm and encroaching on the left optic tract. Computed tomography scanning and magnetic resonance imaging confirmed the presence of an overt hemorrhage, a real apoplectic event of cavernous hemangioma. Cavernous hemangiomas located within the intracranial optic nerve are few. Occult hemorrhage within the confines of the intrinsic vascular humor resulted in acute visual changes in most reported cases. Overt hemorrhage with blood extravasation beyond the original confines of the intrinsic optochiasmal rumor are rarely reported in the literature. Herein, we report one such case. The clinical course and the predisposing factors are also discussed.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A 59-year-old male heart transplant recipient experienced progressive visual loss following routine cataract surgery with intraocular lens implantation. Cranial magnetic resonance (MR) imaging suggested and brain biopsy confirmed the cause to be progressive multifocal leukoencephalopathy (PML). The patient died 2 months following cataract surgery. This case illustrates that visual failure may be the initial manifestation of PML, and the ophthalmologist should be aware of this central de-myelinating disorder when dealing with immunocom-promised patients.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Pulseless disease (PD) is a rare disorder in which inflammation of the aorta and its major branches leads to stenosis or occlusion of these arteries. It mainly affects young Oriental women, who suffer chronic ischemie injury to tissues of the brain, orbits, upper limbs, myocardium, and kidneys. The ophthalmologic features of pulseless disease tend to be late manifestations, and can include ischemia of the retina, choroid, and anterior segment. The inflammatory process may be reversed in early stages with systemic corticosteroids, but, more frequently, significant arterial stenosis necessitates arterial bypass surgery. A 59-year-old Caucasian woman with stenosis of all four major cervical arteries presented with recurrent blurred vision, syncope, mental obtundation, and a remarkable funduscopic appearance due to bilateral orbital hypoperfusion. Her acute symptoms improved slightly on high-dose systemic corticosteroids, and then resolved completely following arterial bypass surgery.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Herpes zoster ophthalmicus is a disease in which the varicella-zoster virus replicates and produces inflammation in the skin of the face supplied by the sensory branches of the ophthalmic division of the trigeminal nerve. It can also cause a conjunctivitis, keratitis, uveitis, extraocular muscle paralysis, and acute retinal necrosis. We found only a single report of this disease as a cause of Horner syndrome. Here we report a case of herpes zoster ophthalmicus that progressed to a sixth nerve palsy and, subsequently, a Horner syndrome. We discuss how the anatomic relationship of the fifth, sixth, and sympathetic nerves in the cavernous sinus provides a route whereby the varicella-zoster virus may produce a Horner syndrome. To our knowledge this is the first fully documented case of Horner syndrome caused by herpes zoster ophthalmicus.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Two patients presented with unilateral dilated and poorly reactive pupils and were found to have a previously unsuspected intraocular iron foreign body. Both of them had normal vision and one had normal color of the iris so that the condition was missed by several physicians. The pupils reacted normally to pilocarpine 1% and also showed response to dilute (0.1%) pilocarpine. There was no response to phospholine iodide. These findings indicate that the mydriasis was due to a local siderotic parasympathetic neuropathy of the pupil.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Botulinum toxin type A (BTTA) was injected in the upper lid of 6 patients to reduce palpebral retraction due to Graves' ophthalmopathy. Five unilateral and one bilateral (all female) cases constitute the present series. Injection of 2.5 to 7.5 units of BTTA in the affected lids produced ptosis of 2 to 3 mm in 5 patients. A bilateral case showed a positive but insufficient response by the third injection. An acceptable position of the affected eyelids was maintained for 1 to 8 months. The drug-effect period varied in every patient, regardless of the dose injected, amount of retraction, or endocrine status (hyper, hypo, or euthyroidism) at the moment of treatment. In 5 of 6 patients BTTA provided acceptable upper lid position without cosmetic discomfort. The early results obtained encouraged the use of botulinum toxin in this entity.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Giant cell arteritis is a systemic necrotizing vasculitis that often causes profound and irreversible visual loss in elderly individuals. We describe a 47-year-old man with fulminant giant cell arteritis whose clinical picture included severe visual loss and several unusual or previously unreported findings. Aggressive treatment with intravenous corticosteroids resulted in a dramatic improvement in the patient's vision. Although no firm conclusions can be drawn from the outcome in a single case, we believe that, in some patients with arteritic ischemie optic neuropathy, aggressive treatment with intravenous corticosteroids may be associated with a better visual prognosis than treatment by the oral route.

ISSN:0272-846X    

出版商:OVID    

年代:1993

数据来源: OVID