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Biomedical subjects

R S Manor

Publications and source records attributed to R S Manor.

At least 19 recordsLinked to original sources

Reading-evoked visual dimming.

PURPOSE: To carry out a neuroradiologic investigation in a monocular 49-year-old patient who during the past five years described symptoms of dimming of central vision in his left eye, which was provoked only by reading. METHODS: Computed tomography and magnetic resonance imaging were performed. RESULTS: An orbital apex intraconal tumor situated laterally to and above the optic nerve was found. CONCLUSIONS: Reading-evoked visual dimming can be a variant of gaze-evoked amaurosis. The optic nerve displaced laterally and superiorly, and stretched by the act of reading, may be compressed between the tumor above and the contracted inferior rectus muscle inferiorly.

Blindness

Orbital porencephalic cyst following penetrating orbitocranial trauma.

In a 10-year-old boy an orbitocranial penetrating wound produced by an umbrella tip caused an orbital roof bone fragment to penetrate up to the anterior part of the third ventricle behind the left foramen of Monro. Hemorrhages and encephalomalacia developed along the trajectory of the fragment and subsequently a porencephalic cyst was formed at this site. Six months after the trauma, increased pressure developed in the left ventricular system due to obstructive hydrocephalus and consequently the porencephalic cyst herniated into the orbit through the orbital roof fracture, producing intermittent diplopia, left exophthalmos, and palpebral swelling. A ventriculo-peritoneal shunt led to shrinkage of the orbital cyst content and resolution of the symptoms.

Child

Relationship between visual acuity and nasal field thresholds in patients with temporal hemianopia.

The area of nasal field found with Goldmann static perimetry and the sum of decibels by Humphrey threshold 30/2 was calculated in normal subjects and in subjects with chiasmatic lesions, temporal field loss, and normal or abnormal visual acuity. There was a significant reduction of the mean of the area of the nasal field by static Goldmann perimetry and of the mean of decibels in the nasal field on Humphrey perimetry in patients with temporal field loss and chiasmatic lesions, as compared with normal controls. There were significant correlations of nasal field depression (Goldmann) and visual acuity and for sums of nasal field decibels (Humphrey) and visual acuity. Thus, a generally depressed nasal field was found in patients with chiasmatic lesions and temporal field loss when accompanied by lowering of visual acuity. This would appear to be the earliest stage of nasal field involvement.

Adult

Pineal germinoma with unilateral blindness. Seeding of germinoma cells in optic nerve sheath.

A 13-year-old boy presented with blindness and loss of the papillomacular bundle in the left eye, bilateral papilledema sparing the area of axonal loss, and Parinaud's syndrome. Computerized tomography (CT) revealed an enlarged kinked left optic nerve and enlarged optic canal as well as a tumor in the pineal area producing hydrocephalus. Magnetic resonance (MR) scans showed multiple spinal metastases. The histological diagnosis was germinoma. On completion of four courses of chemotherapy with cis-platin, vinblastine, and bleomycin, repeated CT of orbita and MR imaging of the spine demonstrated the disappearance of the tumor surrounding the left optic nerve and of the spinal metastases. This is believed to be the first case report of seeding of germinoma into the perioptic arachnoid space.

Adolescent

Entoptic [corrected] phenomena in pregeniculate and postgeniculate hemianopsia with splitting of macula by perimetry.

With splitting of macula by perimetry, the entopic phenomena (the perception of one's own foveal xanthophilic pigment and macular vessel leukocytes) were utilized to study the character of macular sparing or splitting in patients with pregeniculate or postgeniculate hemianopsia. In the pregeniculate group, 11 of 14 eyes perceived the Haidinger brushes figure as a half circle corresponding to the perimetric macular splitting, whereas flying corpuscles were not perceived at all or were less numerous on the hemianoptic side than on the normal field side. In contrast, six of seven patients with postgeniculate lesions perceived the Haidinger brushes figure as a complete circle, four of six perceived fewer flying corpuscles on the hemianoptic side than on the normal field side, and two patients reported perceiving an equal number in all quadrants. This study indicated that in pregeniculate hemianopsia there is usually a true splitting of the macula, whereas in postgeniculate hemianopsia, there is some macular sparing even when perimetry shows macular splitting.

Adolescent

Loss of accommodation produced by peristriate lesion in man?

We observed a bilateral accommodative paresis associated with a spontaneous parieto-occipital hematoma in a 37-year old patient. There was no clinical or computerized tomography (CT) evidence of transtentorial herniation or upper brainstem pathology. With resolution of the hematoma, accommodation returned to normal.

Accommodation, Ocular

Papilledema in traumatic lesion of optic nerve with amaurosis.

A patient with subdural hematoma and right amaurosis resulting from traumatic injury to the optic nerve developed papilledema in both eyes a few days after the trauma. This was interpreted as supplementary proof of the existence of axonal flow in the first weeks after occurrence of the optic axon lesion. In the amaurotic eye, the papilledema was less pronounced and disappeared more rapidly (after 3 weeks, as opposed to 6 weeks for the other eye). The nerve fiber layer disappeared between 4 and 6 weeks after the trauma.

Adult