摘要:

Four patients from Caribbean and Central American countries with ocular disease and serologic evidence of Lyme borreliosis are discussed. To our knowledge this is the first report of Lyme disease from this geographic area. Two patients exhibited ocular inflammatory disease, and two patients developed optic neuropathy. A brief discussion of Lyme borreliosis, its serologic diagnosis, and its treatment is presented.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A 23-year-old obese woman presented with papilledema. Computed tomography showed no intracranial mass lesions and lumbar puncture revealed an increased opening pressure, confirming the diagnosis of pseudotumor cerebri. Standardized echography of the optic nerves was performed immediately before and after lumbar puncture. A marked reduction of cerebrospinal fluid pressure correlated with a decrease in the subarachnoid fluid of the optic nerve sheath.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Endovascular neuroradiologic procedure is the treatment of choice for patients with symptomatic direct carotid cavernous fistulae (CCF) and dural arteriovenous fistulae (DAVF) that failed manual carotid artery/jugular vein compression. Preservation of visual function and the prevention of catastrophic intracranial hemorrhage are the prime therapeutic objectives. The choice of trans-arterial versus transvenous approach is dictated by the pathophysiology, pattern of venous drainage, and the risk/benefit ratio in each patient. In 180 patients with CCF, 95% have been cured with a combination of manual compression, transarterial or transvenous embolization, while 3% have significant complication. In pateints with DAVF, transarterial and transvenous embolization has resulted in clinical cure in 77 and 90%, respectively; the complication rate is between 4–5%. Intra-aneurysmal embolization with silicone detachable balloons in its present stage of development is an acceptable alternative for patients with intracranial aneurysms not otherwise amenable to standard neurosurgical clipping. In aneurysms with a well-defined neck, aneurysm thrombosis with preservation of flow in the parent vessel has been accomplished in 90% of the patients treated. The complication rate in patients presenting with mass effect and subarachnoid hemmorrhage is 5 and 14%, respectively.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A case of steroid-responsive malignant lymphoma of the optic chiasm is reported in a 58-year-old woman presenting with subacute vision loss, headaches, and decreased hearing. The exquisite sensitivity of magnetic resonance imaging (MM) of the parasellar area and the usefulness of MR-directed stereotactic biopsy in identifying a chiasmatic lesion are shown. Primary CNS lymphomas are briefly reviewed. Ophthalmologists will be asked to evaluate patients with malignant lymphoma of the optic chiasm with increased frequency in the future, as CNS lymphomas are expected to be the most common neurological neoplasm by 1991.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Three patients with nonneoplastic hydrocephalus had bilateral paresis of the trochlear nerves. Associated signs, including paresis of upgaze, light-near dissociation of the pupils, and convergence-retraction nystagmus, suggested rostral involvement of the mesencephalon. Trochlear nerve paresis and accompanying signs improved after revision of ventricular shunts in two patients. Bilateral trochlear nerve paresis may be a localizing sign of involvement of the superior medullary velum (the anatomic site of trochlear nerve decussation) by a dilated sylvian aqueduct and/or downward pressure from an enlarged III ventricle.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A 58-year-old woman developed bilateral internuclear ophthalmoplegia, probable right oculosympathetic paresis (Homer's syndrome), and right facial dysesthesias with acute cervical hyperextension upon sustaining a rear-end automobile collision. There was no head trauma. A nuclear magnetic resonance scan revealed a discrete area of increased signal in the tegmentum of the pons to the left. Extensive recovery was noted 1 year later. The acute cervical hyperextension suggested acute shearing and stretching of axons from brain stem deceleration rather than transient vertebral artery ischemia. Intemuclear ophthalmoplegia representing intracranial pathology without direct head trauma has not previously been described with acute cervical hyperextension injury.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Five patients were noted to have increased intraocular pressure (IOP) during evaluation for acute nonarteritic anterior ischemic optic neuropathy (AION). Three of the five had no prior record of IOP elevation; all five had small cup-to-disc ratios. Elevated IOP may be a risk factor for developing AION, especially in eyes with structurally congested optic discs.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A 79-year-old man with diplopia and weakness was found to have necrotizing vasculitis consistent with polyarteritis nodosa on temporal artery biopsy. Although he had no evidence of visceral involvement from vasculitis, he responded well to corticosteroid therapy. This case illustrates a nosological problem that can occur when dealing with a disease that has diverse clinical manifestations and nonspecific laboratory findings. Moreover, this case demonstrates the value of including a branch artery segment when biopsying the temporal artery.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The advent of gadolinium–diethylenetriaminepentaacetic acid (Gd-DTPA), a magnetic resonance imaging (MRI) contrast agent, has significantly improved MRI's diagnostic accuracy by enabling the physician to separate magnetically similar but histologically different tissues. A patient with optic nerve meningioma, whose tumor was clearly demonstrated on Gd-DTPA-enhanced MRI but did not appear on noncontrast MM, is described. The usefulness of contrast agents in MM diagnosis of neuro-ophthalmologic disorders and ophthalmic tumors is emphasized through this case report.

ISSN:0272-846X    

出版商:OVID    

年代:1989

数据来源: OVID