Biomedical subjects

G B Krohel

Publications and source records attributed to G B Krohel.

8 recordsLinked to original sources

PubMed1979

Arachnoidal cyst invading the orbit.

Ipsilateral glaucoma developed in a 51-year-old man with a left-sided temporal lobe arachnoidal cyst. Ultrasonic examination disclosed a cystic orbital lesion adjacent to the optic nerve. Following intracranial decompensation of the arachnoidal cyst, the intraocular pressure dropped markedly. Ultrasonography showed a collapse of the presumed optic nerve sheath cyst. While the exact mechanism producing glaucoma in this patient remains unclear, there was an apparent relationship between the elevated intraocular pressure and the arachnoidal cyst.

Arachnoid↗

PubMed1979

Orbital hemorrhage.

Seventeen patients had spontaneous orbital hemorrhages. The usual symptoms were acute onset of pain, proptosis, and vomiting with decreased vision, limitation of motility, and ecchymosis of the eyelids occurring in some patients. The children often developed a progressive space occupying lesion that simulated a neoplasm. Most patients had underlying venous anomalies, although several elderly patients with atherosclerosis developed arterial hemorrhages with more abrupt and dramatic symptoms. Other associated conditions included hypertension, anemia, labor, and von Willebrand's disease. The visual outcome was good except in the elderly patients, half of whom had severe and permanent visual loss.

Adolescent↗

PubMed1979

Blepharoptosis after traumatic third-nerve palsies.

We evaluated the clinical records of 16 patients with blepharoptosis secondary to direct traumatic third-nerve palsies. Most patients were involved in auto accidents, and had associated skull fractures. Of 12 patients who were followed up for at least one year, ten recovered completely. Over half of the patients had evidence of aberrant regeneration, which could be seen clinically as early as nine weeks after the trauma. Orbital localization of the third-nerve dysfunction carries an excellent prognosis for prompt, spontaneous recovery without aberrant regeneration. Surgical intervention in these cases should be delayed at least one year after the traumatic event, and longer if continued slow but progressive recovery is demonstrated.

Adolescent↗

PubMed1979

Lacrimal gland and fossa lesions: an approach to diagnosis and management.

Lesions of the fossa of the lacrimal gland present special problems in diagnosis and management. Clinical recognition and differentiation of benign mixed cell lacrimal gland tumors from other inflammatory and neoplastic lesions of the lacrimal gland fossa are feasible and should provide the basis for the approach to proper management. Lesions conforming to the clinical picture of benign mixed cell lacrimal gland tumors need not undergo incisional biopsy, but require en bloc excision with adjacent tissues through a lateral orbitotomy to ensure complete excision and to prevent late recurrence. Incisional biopsy is indicated and should not be delayed in suspected infectious and noninfectious inflammatory lesions that have not responded rapidly to medical therapy, and in other lesions suspected of being neoplastic and not amenable to total local excision. An expedient approach to these lesions is essential if the prognosis of epithelial lacrimal gland neoplasms is to be improved.

Adult↗

PubMed1979

Clinical presentation and management of lacrimal gland tumours.

This paper presents the clinical and pathological findings in 40 consecutive patients seen with primary tumours arising from the lacrimal gland. Twenty patients had a benign mixed-cell tumour. They presented in a recognisable clinical manner with a painless mass in the region of the lacrimal gland which slowly enlarged over a period of at least 1 year before consultation. Twenty patients had a carcinoma of the lacrimal gland. They had a short history and experienced pain. On clinical grounds they could not be distinguished from inflammatory lesions in the region of the lacrimal gland. The method of treating these 2 groups of patients is described and methods of dealing logically with their problems are suggested.

Adult↗

PubMed1978

Cortical blepharoptosis.

A 59-year-old man with a previous left frontal lobe infarction sustained an infarction of the right frontal lobe. The patient manifested a bilateral symmetrical blepharoptosis that resolved in two months. Eyelid movements seem to be bilaterally represented in the frontal lobes. Bilateral cortical disease can produce supranuclear eyelid abnormalities such as blepharoptosis, difficulty maintaining eyelid position, and difficulty initiating eyelid movement.

Blepharoptosis↗

PubMed1977

Engelmann's disease.

A 5-year-old boy with diaphyseal dysplasia who exhibited marked involvement of the cranial bones developed marked disk edema in a one-year period. We believed the optic canal was being rapidly compromised by bony proliferation and vision was threatened. Selective bone studies, including tetracycline labeling, demonstrated a rapid accretion of bone 1 1/2 to two times the expected rate for his age. We performed bilateral unroofing of the optic canals with additional temporal decompression of the left orbit. Limited unroofing of the right eye proved to be inadequate and only with additional extensive temporal decompression was the disk edema of the left eye reversed. Tomograms taken one year after surgery revealed regrowth of bone in the optic canal and orbital roof. The usefulness of bony decompression of the orbits in Engelmann's disease is requestionable.

Adolescent↗

PubMed1976

Herpes simplex neuropathy.

Atypical facial pain and permanent sensory loss in the second and third divisions of the trigeminal nerve developed in a patient who had had multiple attacks of herpes simplex neuralgia over a period of 8 years. Intravenous cytosine arabinoside failed to prevent a recurrence of the vasicular eruption, but carbamazepine produced symtomatic pain relief. This case demonstrates that herpes simplex can closely mimic herpes zoster as a cause of postherpetic neuralgia and suggests a possible etiology of atypical facial pain and/or trigeminal sensory neuropaty in some patients.

Adult↗