摘要:

We report a patient with meningovascular syphilis who had a dorsal midbrain syndrome, cognitive dysfunction, and a left peripheral seventh nerve palsy. Magnetic resonance imaging (MRI) disclosed a large lesion of the midbrain and thalamus with intense enhancement of the interpeduncular cistern, both of which resolved after treatment with intravenous penicillin. The clinical features, radiographic appearance, and response to therapy suggest that this lesion was a focal syphilitic inflammatory process, or gumma. We conclude that MRI with intravenous contrast may reveal the full spectrum of pathologic involvement in neurosyphilis and, in certain situations, may obviate the need for biopsy of an associated mass lesion.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Syphilis, the third most common sexually transmitted disease, has numerous clinical manifestations and can remain entirely latent for many years. This article gives an overview of diagnosis, evolution of antibodies, specific cases and types of syphilis, and implications for immunodeficient patients.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A 31 -year-old man who inexplicably lost vision as a child was referred for evaluation of bilateral optic atrophy. Other family members had also suffered unexplained visual loss. He had asymmetric impairment of visual acuity, central scotomas, and optic disc pallor. He also had a tritan color vision defect and excavation of the temporal portion of his optic discs, two features that were consistent with autosomal dominant optic atrophy. However, examination of the mitochondrial DNA of the proband and of two of his relatives revealed a mutation at nucleotide 11778, known to be associated with Leber's hereditary optic neuropathy. This case illustrates the difficulty physicians may encounter when trying to clinically differentiate Leber's from dominant optic atrophy in patients with remote visual loss, and it emphasizes the importance of obtaining a molecular assay for a mitochondrial mutation in cases of ambiguously classified hereditary optic neuropathy.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A 3½-year-old girl with a diagnosis of common acute lymphoblastic leukemia antigen (CALLA)-positive acute lymphoblastic leukemia was noted to be hypertensive and developed a tonic-clonic seizure. Computed tomography scan of the head revealed a right orbital mass. Orbital fine needle aspiration biopsy demonstrated rosette-like arrangements of cells with fibrillar cytoplasmic processes suggesting neuroblastoma. The tumor cells were antineuron-specific enolase positive. The cytologic findings suggested neuroblastoma, a diagnosis confirmed on subsequent work-up. The difficulty in distinguishing neuroblastoma from acute lymphoblastic leukemia in the pediatric patient is discussed in terms of clinical and cytologic features.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Graves' thyroid ophthalmopathy primarily affects women in their third through sixth decade. Sixty-seven patients with clinical myopathic ophthalmic Graves' disease examined (by SCB) between 1982 and 1989 were measured for changes in upgaze intraocular pressure and strabismus. Special attention was paid to “masquerade” symptoms, including pseudosuperior oblique palsies and cyclotorsions. Any correlation between the extent of hypertropia on muscle exam and upgaze intraocular pressure changes is examined. Data suggest that significant changes in introcular pressure in upgaze correlate with more severe extraocular muscle involvement, may represent progression to muscle fibrosis, and occur uniformly in our study of patients who progress to require inferior rectus recession.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Ocular myoclonus developed in our 34-year-old patient 4 months after massive brain stem hemorrhage due to eclampsia. On chronic patching of the left eye, the vertical pendular nystagmus in the fixating right eye disappeared, whereas the covered eye was esotropic. While fixating, the left eye showed horizontal pendular nystagmus. With both eyes fixating, the right eye presented markedly vertical pendular nystagmus and the left eye a horizontal pendular nystagmus. It seems that chronic patching of one eye has a beneficial modulating effect on the vertical pendular nystagmus in the fixating eye.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We describe a patient with a left trochlear nerve paresis and a left relative afferent pupillary defect despite normal visual acuity, color vision, visual fields, and fundus examination. Magnetic resonance imaging revealed a lesion in the right dorsal midbrain extending from the brachium of the superior colliculus to the inferior colliculus. The anatomy and physiology of the pupillary light reflex are reviewed, as are possible mechanisms for the laterality of afferent pupillary defects with midbrain lesions. The presence of a trochlear nerve paresis with an ipsilateral relative afferent pupillary defect and an otherwise normal ophthalmic exam indicates a lesion in the contralateral dorsocaudal midbrain.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We examined three patients with optic disc edema and peripapillary hemorrhages. Each was found by standard echography to have calcified nodules within the retro-bulbar portion of the optic nerves. These nodules were located approximately 2 mm posterior to the lamina cribrosa. Each patient had unilateral congestion of the optic nerve head with dilated, tortuous retinal veins that appeared much like a partial central retinal vein occlusion; one patient subsequently developed optic atrophy. The central location of the calcifications within the anterior aspect of the optic nerves suggests that each nodule may have been situated within the central retinal vein or artery. Calcifications within the retrolaminar space may be associated with some etiologies of unilateral congestion of the optic nerve head.

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1991

数据来源: OVID