PubMed Health⌕ Search

Biomedical subjects

R A Egan

Publications and source records attributed to R A Egan.

9 recordsLinked to original sources
PubMed2003

Remarkable improvement in adult Leigh syndrome with partial cytochrome c oxidase deficiency.

Leigh syndrome (LS) is a heterogeneous disorder, usually due to a defect in oxidative metabolism. Typically, signs and symptoms commence in infancy or childhood, although rare cases of adult onset have been described. Progressive deterioration is the norm. The authors describe a 22-year-old woman with partial cytochrome c oxidase deficiency who developed fulminant LS following an acute febrile illness and who subsequently showed dramatic clinical and neuroradiologic improvement.

Adult↗
PubMed2001

Monocular elevator paresis in neurofibromatosis type 2.

A retrospective review of 29 consecutive unselected patients referred for neuro-ophthalmic evaluation after the diagnosis of neurofibromatosis type 2 (NF2) showed that four of them had a monocular elevator paresis. In two of the four MRI demonstrated lesions, presumed to be schwannomas, of the third nerve. These findings indicate that monocular elevator paresis is a common neuro-ophthalmic finding in NF2, which the authors suspect is probably a sign of third nerve infiltration or compression by a schwannoma.

Adolescent↗
PubMed2001

Monocular blindness as a complication of trigeminal radiofrequency rhizotomy.

PURPOSE: To raise the awareness of the rare complication of monocular blindness resulting from radiofrequency rhizotomy for trigeminal neuralgia. METHODS: Case series from tertiary referral centers. Patients were referred after complaint of loss of vision. RESULTS: We report three patients who had trigeminal neuralgia and underwent treatment by radiofrequency rhizotomy. Each developed complete loss of vision in one eye immediately after the procedure. One patient died of an unrelated cause, and pathologic analysis revealed changes compatible with acute trauma to the right optic nerve. CONCLUSION: Our third case confirms the hypothesis that traumatic optic neuropathy after trigeminal radiofrequency rhizotomy results from malpositioning of the rhizotomy needle through the inferior orbital fissure into the orbital apex rather than the foramen ovale.

Aged↗
PubMed2000

Visual field deficits in conventional anterior temporal lobectomy versus amygdalohippocampectomy.

OBJECTIVE: To evaluate and identify the incidence of visual field defects (VFD) after anterior temporal lobectomy (ATL) versus amygdalohippocampectomy (AH). VFD occur frequently after ATL and are usually superotemporal quadrantanopias. Little is known about the incidence of VFD after AH and this surgical method offers the possibility of a seizure-free survival without visual loss. METHODS: Patients with similar characteristics were examined. All patients had intractable seizures and mesial temporal sclerosis, small tumors localized to only the uncus, amygdala, or hippocampus, or no known pathology. Postoperative kinetic field testing using the I4e isopter on a Goldmann perimeter was performed 30 days or more after surgery. RESULTS: Of 29 patients examined, 14 underwent AH and 15 had ATL. Four of 14 AH patients (28%) had a VFD at 10 degrees from center and 11/14 (78%) had VFD at 40 degrees. One of 15 ATL patients (7%) had a VFD at 10 degrees from center and 11/15 (73%) had VFD at 40 degrees. There was no significant difference between surgery types. CONCLUSIONS: AH in this study was associated with a significant number of VFD. No significant difference was found between the frequency of VFD produced from AH and ATL. The mechanism of injury is due to direct trauma to the optic radiations while accessing the mesial temporal structures. Because all patients in the study were asymptomatic for VFD, it remains to be determined whether these VFD are clinically significant.

Adult↗
PubMed2000

Update on ischemic stroke.

Stroke is the second most common cause of death worldwide, exceeded only by heart disease. Epidemiologic studies have greatly enhanced our understanding of the factors that increase stroke risk. There have also been many recent developments in the understanding of the various etiologies of stroke as well as specific new treatments. The characteristic sudden onset and rapid tissue damage make stroke particularly challenging to treat. The most promising therapy for acute ischemic stroke is the use of a thrombolytic agent. This has been the focus of recent large trials and remains a challenging treatment for cerebral ischemic stroke as well as for retinal artery occlusion. Because neuro-ophthalmic symptoms and signs such as vision loss and diplopia are common in patients with stroke, patients are often seen by ophthalmologists prior to their primary care physicians or neurologists. The ophthalmologist should be aware of some of the new diagnostic and therapeutic issues in the management of patients with acute ischemic stroke. This review emphasizes some of the controversial topics published during the past few years.

Brain Ischemia↗
PubMed1991

Fibronectin immunoreactivity in neural trauma.

The presence of extracellular matrix protein fibronectin (FN) at the site of neural trauma was examined using immunohistochemical methods. At 2, 4 and 7 days following a penetrating wound through the rat cerebral cortex, FN staining was detected in the neuropil and in non-neuronal cells adjacent to the wound. FN-stained cells were GFAP-negative and were identified as brain macrophages based on cell surface staining for CR3 complement receptor. Our findings suggest a role for FN in the repair of neural trauma.

Animals↗