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Biomedical subjects

R H Spector

Publications and source records attributed to R H Spector.

At least 19 recordsLinked to original sources
PubMed1991

Echographic diagnosis of dural carotid-cavernous sinus fistulas.

I used standardized ophthalmic echography to identify specific abnormalities in four patients with low-pressure, low-flow dural arteriovenous malformations. In all of the patients, B-scan ultrasonography showed engorgement of the ipsilateral vertical vein. A-scan ultrasonography dynamically imaged rapid blood flow through the superior ophthalmic vein and enlargement of the culpable ocular muscles in patients with restrictive ophthalmopathy. The 30-degree test distinguished between venous engorgement of the optic nerve sheath and apical compression of the optic nerve by enlarged ocular muscles.

Adult↗
PubMed1987

Minimal thyroid ophthalmopathy.

We studied six patients with the clinical, sonographic, CT, and biochemical profile of minimal euthyroid Graves' disease (MEGD). This syndrome was characterized clinically by small but obtrusive and measurable amounts of diplopia related to endocrine ophthalmopathy and the conspicuous absence of systemic or laboratory signs of thyrotoxicosis. Diagnostic emphasis will be given to certain manifestations of MEGD, namely the clinical patterns of ophthalmoparesis, the results of forced duction testing, orbital ultrasonography, and CT, as well as the need to obtain, in some cases, special antibody studies and the thyrotropin releasing hormone stimulation test.

Adult↗
PubMed1986

The "sinister" Tolosa-Hunt syndrome.

Four patients with presumed Tolosa-Hunt syndrome ultimately proved to have a parasellar tumor. All four had manifestations of a cavernous sinus syndrome, normal radiologic and medical investigations, and response to steroid therapy. The Tolosa-Hunt syndrome is a diagnosis of exclusion; many other lesions can simulate the clinical manifestations, including steroid responsiveness.

Adult↗
PubMed1985

Arnold-Chiari malformation in a geriatric patient.

Downbeat nystagmus was the salient clinical manifestation of an Arnold-Chiari malformation in the 74-year-old woman we have described. Interesting features included the patient's age at the time of diagnosis, the sensitivity of downbeating nystagmus as a localizing neuro-ophthalmologic sign, and the value of metrizamide cisternography in defining lesions of the craniocervical junction.

Aged↗
PubMed1985

Symptomatic Rathke's cleft cysts located entirely in the suprasellar region: review of diagnosis, management, and pathogenesis.

Three cases of an entirely suprasellar symptomatic Rathke's cleft cyst, two of which were associated with normal sella turcicas, are reported. In all cases, the cysts caused compression of the optic chiasm, and two produced hypothalamic dysfunction. The diagnosis of these entirely suprasellar masses was enhanced by metrizamide cisternography. Two cases were treated by frontal craniotomy and one was treated transsphenoidally, with good results in all cases. The radiology, pathology, and surgical treatment of these unusual cases is presented. An embryological pathogenesis for the occurrence of an entirely suprasellar Rathke's cleft cyst is discussed.

Adolescent↗
PubMed1985

Classification and treatment of spontaneous carotid-cavernous sinus fistulas.

An anatomical-angiographic classification for carotid-cavernous sinus fistulas is introduced and a series of 14 patients with spontaneous carotid-cavernous sinus fistulas is reviewed to illustrate the usefulness of such a classification for patient evaluation and treatment. Fistulas are divided into four types: Type A are direct high-flow shunts between the internal carotid artery and the cavernous sinus; Type B are dural shunts between meningeal branches of the internal carotid artery and the cavernous sinus; Type C are dural shunts between meningeal branches of the external carotid artery and the cavernous sinus; and Type D are dural shunts between meningeal branches of both the internal and external carotid arteries and the cavernous sinus. The anatomy, clinical manifestations, angiographic evaluation, indications for therapy, and therapeutic options for spontaneous carotid-cavernous sinus fistulas are discussed.

Aged↗
PubMed1984

Pseudotumor cerebri caused by a synthetic vitamin A preparation.

Pseudotumor cerebri developed in a 14-year-old girl with nodulocystic acne, who was taking excessive amounts of a synthetic vitamin A derivative. Although hypervitaminosis A has reportedly caused pseudotumor, Accutane has not previously been implicated.

Acne Vulgaris↗
PubMed1983

Peripheral facial palsy with intact taste and tearing caused by intrapontine lesion.

Two patients with documented lesions in the floor of the fourth ventricle had unilateral paralysis of the upper and lower facial muscles but normal taste sensation and tearing function. These findings contradict the widely accepted clinical notion that an intraparenchymal lesion of the facial nerve invariably causes loss of gustatory and lacrimal function.

Brain Diseases↗
PubMed1981

Amitriptyline-induced ophthalmoplegia.

Total external ophthalmoplegia, unresponsive to caloric stimulation, was observed in a gravid woman who had ingested approximately 1.0 to 1.5 gm of amitriptyline. The intravenous administration of 4.0 mg physostigmine salicylate (PS) produced a revival of consciousness and reflex activity but had no appreciable effect on ocular motility. A prior case report of amitriptyline-induced ophthalmoplegia in a patient who took lesser amounts of the medication described immediate restoration of eye movement with only 2 mg of intravenous PS. The action of the amitriptyline on the vestibuloocular reflex seems to involve cholinergic transmission and the effect of the drug may be dose related.

Adult↗
PubMed1980

Demyelinative chiamal lesions.

To clarify the clinical syndrome of demyelinative chiasmal involvement, six case histories were analyzed and the literature was reviewed. This entitity is characterized by especial predilection for women in the third to fifth decades; visual deficites of a chiasmal pattern that may be modest to marked, with a generallly good prognosis for functional recovery; and other signs and symptoms, not necessarily severe, of scattered lesions of the neuraxis. Neuroradiological studies, especially laminography of the sellar area and computerized tomography, must be employed to rule out a suprasellar mass lesion. The efficacy of systemic corticosteroid therapy is moot, but it seems reasonable to use such agents during acute stages, especially where vision is severely reduced on both sides.

Adult↗
PubMed1980

Downbeat nystagmus as the salient manifestation of the Arnold-Chiari malformation.

A case of Arnold-Chiari malformation Type I presented with the isolated finding of downbeat nystagmus. The mechanism of downbeat nystagmus is discussed along with its subjective manifestation referred to as oscillopsia. In addition, the value of metrizamide cisternography in diagnosing the Arnold-Chiari malformation is illustrated.

Adult↗