ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A 78-year-old hypertensive woman suddenly developed blurred vision, followed shortly by dizziness, difficulty walking with a tendency to veer to the left, and vertical diplopia. Examination 3 weeks later revealed a unique neuro-ophthalmologic motility pattern, which may be described asperiodic alternating skew deviation.This previously unreported motility disturbance was associated with downbeat nystagmus in our patient, and a focal lesion at the level of the interstitial nucleus of Cajal was demonstrated on computed tomography. The spectrum of physiologically related motility patternsh–including periodic alternating nystagmus, cyclic oculomotor paralysis, see-saw nystagmus, periodic alternating gaze deviation, “ping-pong” gaze, and intermittent aperiodic alternating skew deviation–has been considered and is helpful in topical neuro-ophthalmologic diagnosis

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Progressive loss of vision, optic disc pallor, and optociliary shunt vessels (the Hoyt-Spencer sign) constitute the clinical triad of optic nerve sheath meningiomas. However, optociliary shunt vessels may also follow central vein occlusions, and less commonly occur with a few other conditions. This report presents a comparative study of fluorescein angiograms performed on eight patients with optociliary shunt vessels. Four patients had optic nerve sheath meningiomas, and four patients had central retinal vein occlusions. The following differences in the fluorescein angiograms were noted in the two groups. In the optic nerve sheath meningioma group, the shunt vessels fill earlier (in the arteriovenous phase), the flow drains to central venous tributaries, and the late staining is hy-perfluorescent to other veins. However, in the central vein occlusion group, the shunts fill later (in the venous phase), show a flow draining to the outer disc margin, and late staining is eufluorescent with other veins. Although optic nerve sheath meningiomas and old vein occlusions are usually rather easily differentiated by a complete examination, the fluorescein angiographic patterns are not only pertinent with regards to the pathogenesis of optociliary vessels, but in certain cases may be clinically helpful in making an important clinical differentiation

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A 16-year-old white girl with neurofibromatosis was documented as having progressive visual loss in both eyes over 3 years before diagnosis of a chiasmal glioma. She was then treated with supervoltage irradiation to the sella and parasellar area. Bitemporal fields measuring 5 X 5 cm each were initially used, and source skin distance of 80 cm with coplanar opposing technique was used whereby each field was treated daily to a midplane dose of 186 rads. The patient received a cumulative tumor dose over the 5-week course of 4680 rads. She tolerated this well, and her visual function was stabilized thereafter for over a year. Two years following therapy, she expired suddenly and unexpectedly at home.At autopsy, there was no radionecrosis in the brain or optic nerves, but minimal radiation changes were seen in the tumor. Extensive local invasion was seen in the entire chiasm, adjacent optic tracts and hypothalamus. In addition, other disparate small fibrillary astrocytic gliomas were found in the optic radiations, midbrain, and left anterior midfrontal lobe. This patient therefore documents clinically progressive visual deterioration before irradiation therapy, and palliative visual function stability for well over a year after irradiation therapy. The patient also demonstrates the difficulty in treating a locally aggressive optic chiasmal glioma, its infiltrative nature, and the multifocality of other unsuspected neural tumors in neurofibromatosis.

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Three cases are presented of subperiosteal hematomas, which can be thought of as epidural hematomas of the orbit. One occurred in a child associated with an episode of violent vomiting, the second in an adult with a history of remote head trauma who presented with a slowly progressive course suggestive of thyroid eye disease, and the third in a young patient after acute trauma probably associated with the injections of a local anesthetic agent or possibly the passage of a deep suture. Skull x-rays, computed tomography, and ultrasonographic examinations detected and localized the lesion in each case. Both patients who were operated on enjoyed prompt and total resolution of their symptoms after surgical extirpation of the lesion. In the third patient, the lesion regressed on its own.

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Stellate ganglion block for relief of pain and prevention of ophthalmic complications in trigeminal herpes zoster has been advised for many years. In a series of 27 patients, control of pain was dramatic after local anesthetic block of the stellate ganglion. This report is presented to stimulate renewed interest in this old form of therapy. Because of the retrospective nature of this investigation, the lack of adequate numbers and the absence of controls, no conclusions on efficacy of treatment can be made. However, enough hope of success is presented to justify a controlled series in a large metropolitan area where adequate numbers of patients can be accumulated for a double-blind protocol

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1981

数据来源: OVID