PubMed Health⌕ Search

Biomedical subjects

T R Hedges

Publications and source records attributed to T R Hedges.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Spasmus nutans--or is it?

At age 3 1/2 years a child developed what appeared to be classic spasmus nutans. Thorough discussions as to the propriety of neuroimaging studies in such patients are presented. With this late age of onset, the presence of a compressive lesion was suspected and neuroimaging demonstrated a sellar-suprasellar mass lesion.

Astrocytoma↗
PubMedDate not supplied

Bilateral visual loss in a child with disc swelling.

A nine-year-old girl developed periorbital pain followed by sequential visual loss over a 3-day period. The patient recovered vision to a 20/40 level over a 5-month period of time. The differential diagnosis and evaluation in this presentation is discussed. The patient is believed to have had an idiopathic or parainfectious optic neuritis.

Blindness↗
PubMedDate not supplied

Ophthalmoplegia associated with AIDS.

A 34-year-old man with AIDS was admitted to the hospital with a one-week history of cough, chest pain, and fever. Radiography revealed a cavitating left upper lobe lesion. Two weeks later he developed a headache associated with a contrast enhancing lesion in the right parietal lobe. The patient had a progressive downhill course, developing atrioventricular block and hypernatremia. Neuro-ophthalmologically, there was a mild facial droop, "hand motions" vision with presumed bilateral cytomegalic inclusion retinitis, and signs of a mesencephalic syndrome, including lid retraction. Discussions center on the differential diagnosis of the central nervous system disease and the obligative recommendations the neuro-ophthalmologist must be willing to make.

AIDS Dementia Complex↗
PubMedDate not supplied

Two brothers with bilateral optic neuropathy.

A young man developed bilateral, consecutive, optic neuropathy. His brother had had a similar problem and recovered after one year. Mitochondrial DNA analysis showed that both had the 14484 mutation associated with Leber's hereditary optic neuropathy.

Adolescent↗
PubMedDate not supplied

Epidemic optic and peripheral neuropathy in Cuba: a unique geopolitical public health problem.

During 1992 and 1993 an epidemic of optic and peripheral neuropathy affected over 50,000 Cubans. This occurred in the unique setting of a communist country which had a widespread health care network and wherein sudden changes in the economy affected most of the population. Although nutritional factors appeared to play a key role in the pathogenesis of the epidemic neuropathy, viral, toxic, and genetic factors were investigated by Cuban and North American scientists. The authors, representing different disciplines and different groups that visited Cuba during the epidemic, review and reflect on the clinical and laboratory findings which became available through their own experience and through reviewing the literature. The recent Cuban epidemic is compared to similar outbreaks of optic and peripheral neuropathy which have occurred in the past.

Alcohol Drinking↗
PubMedDate not supplied

The terminology of transient visual loss due to vascular insufficiency.

Transient visual loss due to cerebro-ocular vascular disease is a common symptom. The purpose of this paper is to present a unified terminology of the monocular vs. binocular or homonymous types. Lack of proper identification may lead to mis-diagnosis and improper management of these entities. Monocular blurred vision must be investigated since its origin is so commonly due to atherosclerosis of the carotid system. Binocular blurred vision due to vertebro-basilar insufficiency is managed conservatively in almost all instances.

Blindness↗
PubMedDate not supplied

Isolated ophthalmic migraine in the differential diagnosis of cerebro-ocular ischemia.

Thirty-three of 129 patients who incurred isolated ophthalmic migraine had monocular attacks of scotomatous visual field loss. Fifteen of 33 patients with monocular attacks had immediate or remote evidence of vascular disease. Four patients had carotid bruits on the same side as the monocular attacks and low ophthalmodynamometer readings. One patient had ischemic optic neuropathy and two had atheromatous disease (advanced stage in one patient). Forty-five percent of the patients with monocular attacks and only 13% of the remaining patients with homonymous attacks had vascular complications. This represents an important finding even in such a small group of patients. It is felt that, whether the vascular problems are trigger mechanisms or coexistence pathology to the migraine-type attack, one should strongly suspect such an association when a patient describes a monocular attack and one should look for a possible vascular explanation other than migraine.

Age Factors↗
PubMedDate not supplied

Congenital glaucoma and skeletal dysplasia.

We have observed congenital glaucoma in a patient with a skeletal dysplasia closely resembling Kniest syndrome. The clinical and radiographic features, along with the differential diagnosis of Kniest syndrome, are discussed. Review of the literature suggests a relationship between the pathophysiology of bone dysplasia and congenital glaucoma. Congenital glaucoma may be an additional ocular finding in Kniest syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

Hypertropia following trochlear trauma.

Hypertropia following trauma to the trochlea is rare. The more widely recognized response of the trochlea to trauma is hypotropia or acquired Brown syndrome. We observed three cases of hypertropia following penetrating trauma to the trochlea. Each had computerized tomography and/or magnetic resonance imaging to assist in the understanding of the mechanism of the observed superior oblique dysfunction. The clinical course of these cases was variable. Awareness of the damaged trochlea's capacity to respond as a hypertropic as well as a hypotropic syndrome will allow for improved management of these unusual patients.

Adolescent↗
PubMedDate not supplied

Papilledema: its recognition and relation to increased intracranial pressure.

This has been a review on the subject of papilledema from a clinical, pathologic and experimental point of view. Terminology has been clarified. The term papilledema should be reserved for those patients with optic disc edema caused by increased intracranial pressure. The forms of papilledema which are identifiable are: 1. Early (incipient) form which develops into an acute type and then into a fully developed form; 2. Fully developed form, characterized by obscured disc margins, hemorrhages and ischemic infarcts; 3. Chronic papilledema which may persist (the name "vintage" papilledema may be applied to those patients affected in varying degrees up to several years); and 4. Chronic atrophic papilledema which, as the name implies, illustrates a form we do not see as frequently as in years past. It is the type we are now trying to prevent and in this effort we are fortunately achieveing some success. The importance of the intracranial expanding lesions and the influence of the rapidity of elevation and duration of intracranial hypertension on the optic nerve has been considered, based on the clinical and experimental work to date. The pathogenesis of papilledema has been considered in some detail. A unified whole is difficult to arrive at in such a complex situation. Recent advances in our understanding of anatomic, mechanical (sheath space pressure), tissue and vascular pressure as related to increased intracranial pressure have been described. A hydrostatic mechanism brings these factors together in a reasonable, although admittedly not completely proven concept of a mechanism for the development of papilledema. Clarification of terminology and clinical appearance of the various forms of disc edema related to intracranial pressure are of practical value in the diagnosis and management of each patient we see with this clinical entity.

Acute Disease↗
PubMedDate not supplied

A cliniconeuroradiologic approach to third cranial nerve palsies.

Sixty-three patients with third cranial nerve palsies (CNPs), either isolated (31) or in association with other neurologic deficits (32), underwent neuroophthalmologic and neuroradiologic evaluation. Discrepancies between the clinical and radiologic evaluations were analyzed and useful clinical presenting symptoms were identified. Microvascular infarction secondary to diabetes mellitus and/or hypertension was the most common cause in patients with isolated third CNP, and extensive neuroradiologic evaluation is not indicated in this subgroup. The overall diagnostic yield of high-resolution CT for isolated third CNPs was low (30%), but improved to 60% if diabetes and hypertension were excluded. However, CT was highly sensitive (90%) in those patients with third CNPs associated with additional neurologic deficits. The status of the pupil in and of itself cannot be the sole determinant as to whether angiography is indicated to exclude an aneurysm. Careful ophthalmologic observation and relating the severity of pupillomotor dysfunction to extraocular ophthalmoplegia is mandatory to determine the logical sequence of radiologic evaluation. Retroorbital pain taken in isolation is a nonspecific presenting symptom and has differential diagnostic value only if it is correlated temporally with the onset of third CNP and the presence or absence of additional cranial nerve deficits.

Adolescent↗
PubMedDate not supplied

Color Doppler imaging of the eye and orbit.

1. The use of color doppler imaging (CDI) in ophthalmology is a new and exciting area in vascular imaging. The physiologic information obtained and the anatomy evaluated has been inaccessible by any other noninvasive or invasive technique. 2. Although CDI for ophthalmic use does not, as of this time, have FDA approval, clinical trials have begun. 3. It is our expectation that CDI will be an accurate, reproducible, noninvasive method to assist ophthalmologists in the diagnosis and treatment of patients with orbital and ocular vascular disease.

Eye↗