ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo determine long-term (>10 years) visual outcome in patients with suprasellar meningiomas.MethodsRetrospective case series.ResultsAmong 18 patients who underwent surgery for suprasellar meningioma (1 patient died postoperatively), 1 experienced initial improvement in vision in both eyes, 8 experienced improvement in vision in one eye and maintained stable vision in the other eye, 2 experienced improvement in vision in one eye and worsening of vision in the other, 3 experienced worsening of vision in one eye and stable vision in one eye, and 4 maintained stable visual acuity in both eyes. No patient experienced postoperative worsening of vision in both eyes.During 10 years or more of follow-up, 10 of the patients (56%) maintained stable vision in both eyes, 6 patients (33%) experienced loss of vision in one eye while maintaining stable vision in the other, and 2 patients (11%) experienced loss of vision in both eyes. During this period, 7 of the 18 patients (39%) developed neuroimaging evidence of tumor growth or recurrence, with a mean time of 10.7 years. Four of these patients were thought to have had gross total resection of their tumor. Patients who experienced worsening of vision during the follow-up period were more likely to have developed neuroimaging evidence of growth or recurrence (five patients) than patients without such evidence (two patients), and such patients did not regain vision following subsequent surgery or radiation therapy. Nevertheless, at final examination, 13 patients (72%) had visual acuity of 20/40 or better in at least one eye.ConclusionsThe long-term visual prognosis for patients who undergo surgery for suprasellar meningioma is excellent, although tumor recurrence is common, even in patients thought to have undergone gross total removal of their tumor, and often occurs more than 10 years after surgery. Patients who develop tumor recurrence are likely to lose vision in at least one eye and are unlikely to achieve improvement in vision with subsequent surgery or radiation therapy. Thus, patients with suprasellar meningiomas believed to have been completely resected should undergo long-term, serial postoperative clinical examinations and neuroimaging to allow detection and further treatment of recurrences as early as possible. Postoperative radiation therapy should be considered for patients whose suprasellar meningiomas have been incompletely resected.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo identify blinking-induced functional magnetic resonance imaging (fMRI) activation patterns in five benign essential blepharospasm (BEB) patients and five age-matched control subjects.MethodsfMRI brain activation maps were obtained during repeated conditions of spontaneous and voluntary blinking in BEB and control groups. Blood oxygen level–dependent intensity images were collected from two separate runs as 16 axial and 16 coronal, 8 mm thick slices using a T2-star weighted gradient echo EPI sequence, coregistered with anatomic images. Spatially normalized and isotropically blurred activation maps for each subject were combined within groups of BEB patients and control subjects to generate maps of the intersubject mean fractional signal change.ResultsSubstantially greater activation during spontaneous and voluntary blinking was seen in BEB patients compared with control subjects in the anterior visual cortex, anterior cingulate cortex, primary motor cortex, central region of the thalamus, and superior cerebellum. In both groups, activations were generally greater for voluntary than for spontaneous blinking.ConclusionsThe activations observed might represent a hyperactive cortical circuit linking visual cortex, limbic system, supplementary motor cortex, cerebellum, and supranuclear motor pathways innervating the periorbital muscles.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 23-year-old woman who presented with a branch retinal artery occlusion followed by encephalopathy showed, by brain magnetic resonance imaging, a nonenhancing lesion in the right parietal gray matter with normal diffusion-weighted imaging. Of 64 reported cases of cat-scratch encephalopathy with documented neuroimaging findings, only 12 (18.8%) have had abnormal imaging findings. The abnormalities have included cerebral white matter lesions, basal ganglia and thalamic lesions, and multifocal lesions in immunocompromised patients, but no gray matter lesions similar to those in this patient. The variety of neuroimaging findings supports multiple pathophysiologic mechanisms of central nervous system involvement in this disorder.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A patient with Horner syndrome from internal carotid artery dissection initially had a false negative hydroxyamphetamine test. Two months later, the ophthalmic signs had disappeared but the hydroxyamphetamine test was positive. This case illustrates that hydroxyamphetamine testing may be falsely negative in acute Horner syndrome because norepinephrine stores in oculosympathetic postganglionic terminals have not yet been depleted. However, the hydroxyamphetamine test may be positive even after the ophthalmic signs of Horner syndrome have disappeared.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 52-year-old woman presented with pain, decreased visual acuity, decreased color vision, and visual field loss in the OD. Fundus examination revealed optic disc edema and later a macular star figure consistent with neuroretinitis. Magnetic resonance imaging showed enhancement of the orbital optic nerve sheath and perineural fat suggestive of optic perineuritis. The patient was not treated. At 11 months, visual function and fundus examination had returned to normal. This unusual simultaneous occurrence of neuroretinitis and optic perineuritis suggests that these two entities may have a similar pathogenesis.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 30-year-old man with Leber hereditary optic neuropathy mutation 11778 displayed no magnetic resonance imaging abnormalities during the acute phase of visual loss in the right eye. Three months later, during the acute phase of visual loss in the left eye, magnetic resonance imaging showed T2 hyperintense signal changes on the right half of the optic chiasm. Six months later, magnetic resonance imaging revealed T2 hyperintense signal changes on both sides of the optic chiasm. This is the first reported case of optic chiasmal involvement on magnetic resonance imaging in the atrophic phase of Leber hereditary optic neuropathy.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 44-year-old woman with progressive monocular visual loss was found to have ipsilateral optic disc drusen and an ipsilateral orbital apex mass compressing the optic nerve. The mass, not the drusen, was considered responsible for the worsening vision. Visual loss should not be glibly attributed to drusen, particularly if the visual loss is rapidly progressive. Retrobulbar imaging should be considered in such cases.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Positron emission tomography and single-photon emission computed tomography are nuclear imaging modalities that excel in depicting the biological function of tissue. Unlike structural imaging methods, they provide functional diagnostic information about brain neoplasms, stroke, neurodegenerative disorders, epilepsy, cortical visual loss, and migraine.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The development of personal computer-based infrared video instruments has allowed pupillography to enter the clinical arena. Measuring pupil diameter for refractive surgery, distinguishing Horner syndrome from physiologic anisocoria, quantifying the relative afferent pupillary defect, and plotting visual fields by means of graded pupil constriction to focal light stimuli are recent applications in ophthalmology. Pupillography has also been used to determine sleepiness and autonomic effects of new pharmaceuticals.

ISSN:1070-8022    

出版商:OVID    

年代:2003

数据来源: OVID