Biomedical subjects

S E Kelman

Publications and source records attributed to S E Kelman.

6 recordsLinked to original sources

PubMed1992

Optic nerve decompression surgery improves visual function in patients with pseudotumor cerebri.

Papilledema from pseudotumor cerebri can cause severe loss of visual acuity and visual field. We performed optic nerve decompression surgery on 17 patients with pseudotumor cerebri who, despite maximum conventional therapy, developed progressive loss of visual acuity and/or visual field. Postoperatively, visual acuity improved or stabilized in 33 of 34 eyes (97%). Visual fields improved in 20 of 21 eyes that underwent surgery. Optic nerve decompression surgery relieves local cerebrospinal fluid pressure on the optic nerve. Progressive loss of visual function associated with pseudotumor cerebri can be reversed or stabilized with optic nerve sheath decompression surgery.

Adolescent↗

PubMed1991

Optic nerve sheath decompression for nonarteritic ischemic optic neuropathy improves multiple visual function measurements.

Optic nerve sheath decompression was performed in seven patients with nonarteritic anterior ischemic optic neuropathy. Visual function was evaluated by measurement of visual acuity with standardized Early Treatment Diabetic Retinopathy Study charts, color vision testing, quantitation of relative afferent pupillary defects with neutral-density filters, and Goldmann and Humphrey perimetry. Visual acuity improved markedly in all patients (at least doubling of the visual angle); the peripheral visual field expanded by at least 20 degrees (as measured by Goldmann perimetry) in six patients. Three patients also experienced marked improvement in color vision, relative afferent pupillary defect, and foveal sensitivity. Our experience supports the possible beneficial effect of optic nerve sheath decompression in patients with nonarteritic anterior ischemic optic neuropathy.

Aged↗

PubMed1991

Modified optic nerve decompression in patients with functioning lumboperitoneal shunts and progressive visual loss.

Chronic papilledema from pseudotumor cerebri can cause progressive visual loss despite functioning lumboperitoneal shunts. The authors performed modified optic nerve sheath decompression in 12 patients (16 operations) with functioning lumboperitoneal shunts and progressive visual loss. All of the patients demonstrated improvement in visual function. Optic nerve sheath decompression allows release of localized cerebrospinal fluid (CSF) pressure. By performing optic nerve sheath decompression, progressive visual loss secondary to chronic papilledema can be halted and reversed.

Adult↗

PubMed1991

Orbital roof "blow-in" fractures.

Seven patients with significant frontal trauma involving the supraorbital region associated with orbital roof "blow-in" fractures were admitted to the Maryland Institute for Emergency Medical Services Systems (MIEMSS) at the University of Maryland Medical System over a 16-month period. High-resolution computed tomography (HRCT) with three-dimensional reconstructions demonstrated a downward displacement of the orbital roof in the absence of any orbital rim discontinuity. Associated findings included contussive and hemorrhagic injury to the ipsilateral frontal and parietal lobes, proptosis, ptosis, chemosis, orbital hematoma, and optic nerve contusion. The only long-term ocular pathology in this group of patients was mild to severe optic atrophy. It is recommended that all patients with frontal bone trauma have thin-cut computed tomographic evaluation of the orbit.

Accidents, Traffic↗

PubMed1989

Traumatic trochlear nerve palsy diagnosed by magnetic resonance imaging: case report and review of the literature.

Although head trauma is the leading cause of acquired trochlear nerve dysfunction, it receives little attention in the neurosurgical literature. A case is reported of closed head injury that resulted in a right superior oblique palsy in association with incoordination on the left side. Diagnostic imaging revealed a normal cranial computed tomographic scan and a left dorsal midbrain lesion on magnetic resonance imaging scan. The relevant anatomy is reviewed, as well as the action of the superior oblique muscle, its agonists and antagonists, and the clinical manifestations of superior oblique dysfunction. This case is one of the few we are aware of in which a relatively isolated trochlear nerve palsy is the result of a lesion that can be documented by diagnostic imaging, and the first in which the imaging modality is magnetic resonance imaging scan.

Adult↗

PubMedDate not supplied

Orbital "blow-in" fractures: clinical and CT features.

During a 16 month period, seven patients were admitted to our trauma center with "blow-in" fractures of the orbital roof. This injury results from a significant direct blunt force applied to the supraorbital region of the frontal bone with transmission of energy to the thin orbital plate of this bone and displacement of bone fragments downward into the superior orbit. High resolution CT with multiplanar reformation and three-dimensional display proved very useful in identifying and characterizing the bone and soft tissue abnormalities found in our patients. Our experience suggests that CT demonstration of supraorbital frontal bone fractures and/or frontal lobe cerebral contusions is an indication for thin section CT of the entire orbit, even when there is no evidence of a superior orbital rim fracture. Demonstration of an orbital blow-in fracture should prompt careful clinical assessment of the globe, optic nerve, and extraocular muscles to identify and appropriately manage underlying injuries to these structures.

Adolescent↗