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At least 973 records · Page 54Linked to original sources
PubMed1990

[Chiasmal radionecrosis after irradiation of the sella turcica using a conventional dosage. Contribution of magnetic resonance imaging].

A 47 year-old man developed rapid visual loss, visual field defects and memory disturbances after radiotherapy with conventional doses for a pituitary metastasis from a renal carcinoma. CT and MRI did not show recurrent tumour, pituitary apoplexy or empty sella. Eventually, T2-weighted MRI images showed abnormal high signals in the optic chiasm, the left mesial temporal lobe and the right inferior frontal lobe, supporting the diagnosis of delayed radionecrosis. The role of chemotherapy associated with radiotherapy is discussed.

Female↗
PubMedDate not supplied

Significance of CT and MR findings in sphenoid sinus disease.

Disorders of the paranasal sinuses, particularly the sphenoid sinus, can be associated with significant disorders of the optic and other cranial nerves. We examined 100 consecutive routine CT scans, 100 posterior fossa CT scans, and 100 MR scans to look for evidence of sinus disease, especially of the sphenoid sinus. The sphenoid sinus was abnormal in 7% of scans by all methods. Other sinuses were more frequently abnormal, including maxillary (23%), ethmoid (34%), and frontal (16%). Although MR was more sensitive in detecting sinus inflammation in the ethmoid and maxillary sinuses, the frequency of visible sphenoid sinus abnormalities detected by MR was not significantly greater when compared with CT. Of those patients with abnormal sphenoid sinuses, 24% had visual problems associated with the abnormality.

Adult↗
PubMed1989

Schilder's myelinoclastic diffuse sclerosis.

We report here a case of Schilder's myelinoclastic diffuse sclerosis in a 14-year-old girl with sudden bilateral visual loss. Computed tomographic scan showed two large symmetrical lesions in the occipital lobes and a smaller hypodense area in the frontal lobe. Cerebrospinal fluid examination revealed increased immunoglobulin G fraction with the presence of oligoclonal bands. Ultrastructural study of a biopsy specimen disclosed a demyelinating disorder with no cytoplasmic inclusions. Steroid treatment was followed by a dramatic response, with almost complete visual recovery and shrinkage of the lesions.

Adolescent↗
PubMed1989

Neurological visual fields.

Neurological visual field defects represent lesions to the visual pathway, some of which may be life-threatening. It is, therefore, crucial that optometrists understand how to diagnose these lesions, so they may know when, and to whom to refer the patient. The following cases illustrate the management of patients with lesions to the prechiasmal, chiasmal, and postchiasmal visual pathway.

Adenoma, Chromophobe↗
PubMed1989

"Top of the basilar" syndrome: a clinical and CT analysis.

Fifteen patients presenting with visual, oculomotor and behavioural disturbances were diagnosed to be suffering from "top of the basilar" syndrome. Computed tomography confirmed the distribution of infarctions in the vascular territory of the rostral basilar artery. The clinical profile comprised cortical blindness and visual field defects, vertical gaze paresis, memory and behavioural disturbances and in one patient, the paramedian diencephalic syndrome.

Adult↗
PubMed1989

[The Balint syndrome].

This paper reports a case of complete form of Bálint syndrome. A 56-year-old male suffered form psychic paralysis of gaze, impaired visual attention and optic ataxia of sudden onset in the basis of sequlae of cerebral vascular disease. CT scans of the present case demonstrated low densities in the left frontal, parietal lobe and right basal ganglia, right parito-occipital lobe. As for possible anatomical substrate of the Balint syndrome. according to Damasio's atlas, the authors inferred that despit the multiplicity of lesions in the present case, prefrontal area, lobulus paritalis inferior gyrus angularis and the associated fibers between the prefrontal area and 18, 19 area of occipital lobe were considered to be most responsible for the production of the Balint syndrome.

Brain↗
PubMed1985

Compressive optic neuropathy and ependymoma of the third ventricle.

Progressive monocular visual loss was the presenting manifestation of a cystic ependymoma arising from the third ventricle. Extracerebral extension of the tumor into the prechiasmatic cistern compressed the right optic nerve. Subfrontal extension caused erosion of the planum sphenoidale. Subtotal excision of the tumor was followed by cranial irradiation, and no further visual loss occurred. Extracerebral growth of primary intracerebral gliomas may cause optic neuropathy that is indistinguishable from other compressive neuropathies.

Adult↗
PubMed1986

Acute, severe, symmetric visual loss with cecocentral scotomas due to olfactory groove meningioma.

Cecocentral scotomas are a hallmark of toxic, metabolic, and hereditary optic neuropathies, but are rarely associated with compressive processes. Acute visual loss due to a compressive optic neuropathy by a benign tumor is unusual unless intratumoral hemorrhage or infarction occurs. A case of acute, severe, remitting, symmetrical visual loss with cecocentral scotomas, initially thought to be of toxic etiology, proved to be due to a typical suprasellar meningioma originating in the olfactory groove. A history of olfactory disturbance with visual loss should prompt neuroradiologic investigation despite atypical neuro-ophthalmic features.

Adult↗
PubMed1987

Visual loss in cryptococcal meningitis.

Optic neuropathy with visual loss is a well-known complication of chronic elevated intracranial pressure. The association of visual loss with cryptococcal meningitis may reflect the intracranial hypertension often seen in this condition. However, the generally poor results of optic nerve sheath fenestration and analysis of autopsy cases have led to the suggestion that direct invasion of the visual system by organisms may be the more common mechanism of visual loss. We describe a patient with severe visual loss from cryptococcal meningitis in whom organisms were demonstrated in the optic nerve sheath obtained at the time of fenestration. This is the first report to demonstrate this finding in a living patient.

Adult↗
PubMed1986

Ocular findings in juvenile nasopharyngeal angiofibroma.

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. While histologically benign, it has the propensity for aggressive local growth. This highly vascular tumor predominantly occurs in adolescent males. The literature fails to provide a thorough description of ocular complications and their incidence in JNA. This report summarizes the data from those clinical series detailing ocular findings in a total of 218 JNA cases. Exophthalmos was found in 14% of all cases. Decreased visual acuity and partial ophthalmoplegia occurred in 5% and 2% respectively. Recognition of ocular involvement in JNA is of the utmost importance, for it is often a manifestation of orbital or intracranial extension or both. We describe the diagnosis and management of a case of JNA in a five-year-old white male. The patient developed ocular findings of marked exophthalmos and optic atrophy. Early multidisciplinary diagnostic evaluation (otolaryngological, neurosurgical, and ophthalmological) followed by a team surgical approach to excision is most likely to yield efficacious results.

Child, Preschool↗
PubMed1988

[Monostotic fibrous dysplasia of the sphenoidal bone presenting with visual disturbance during pregnancy].

A case of monostotic fibrous dysplasia in the anterior skull base, which presented with visual disturbance during pregnancy, is reported. A 32-year-old female was referred to our department for examination of the progressing right visual disturbance in the third trimester of her second pregnancy. She had experienced the same episode in her first pregnancy, recovering from it after delivery. This time, however, the visual acuity did not change after delivery. Plain craniogram showed sclerotic changes in the right sphenoidal ridge and the right frontal skull base. CT scan showed an isodense mass which was enhanced by contrast medium in the right sphenoidal sinus. Angiography demonstrated no positive findings. RI bone scintigram using 99 m Tc-MDP revealed an abnormal uptake in this region. The patient was operated on in two stages. The first operation was transsphenoidal removal of the tumor in the sphenoidal sinus. The pathological diagnosis was fibrous dysplasia. Transfrontal decompression of the right optic canal and ophthalmic artery was performed at the second operation. The tumor was totally removed and the decompressed orbital roof was reconstructed using an alumina ceramic plate. Visual acuity gradually improved in the follow-up study. To our best knowledge, only one case of fibrous dysplasia with growth during pregnancy have been reported; it was monostotic fibrous dysplasia of the maxilla. From the clinical course of our case, it is suggested that the pregnancy influenced growth of the monostotic fibrous dysplasia; possibly by way of hypothalamic hormonal factor.

Female↗
PubMed1988

Optic nerve involvement as the initial manifestation of sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown cause. It may have several diverse manifestations that may be progressive yet develop slowly. Ocular disease may occur with inactive systemic disease. We describe two patients in whom optic nerve involvement was the first manifestation of sarcoidosis and clinically mimicked an optic nerve tumour. Sarcoidosis involving the optic nerve should be considered when an optic nerve tumour is suspected.

Adult↗
PubMed1987

[Fibrous dysplasia and ossifying fibroma of the base of the skull. Apropos of 6 cases].

The authors report 6 cases of fibrous dysplasia (F.D.) of the base of the skull and review the literature. They confirm the impossibility of histological differentiation between ossifying fibroma and monostic dysplasia with cranio-facial sites. They stress the value of CAT scan in the assessment of spread and that of dynamic isotope scan in the differential diagnosis with plaque-shaped hyperostotic meningioma, in the diagnosis of polyostotic forms and in postoperative surveillance. They stress the risk of visual sensorial impairment: visual by stenosis of the optic canals and auditory by stenosis of the E.A.M. Operative indications are influenced by this risk, thereby explaining the need for prolonged surveillance.

Adolescent↗
PubMedDate not supplied

[Alexia without agraphia. Anatomical basis and physiopathological mechanisms].

Clinical, neuropsychological and radiological signs were studied in a patient suffering from pure alexia associated with right superior quadrantanopia. The lesion responsible for the defects was located in the periventricular white substance at the level of the left inferior occipitotemporal convolutions. These structures seem to constitute the pathway of the visual information channelled from the two hemispheres towards the language centres. The lesion therefore disconnects the angular gyrus from its visual information and gives rise to alexia without agraphia.

Aged↗
PubMed1987

Multiple sclerosis mimicking primary brain tumor.

Surgical biopsy specimens of multiple sclerosis plaques have been only infrequently reported, and the scanty descriptions of these specimens have generally emphasized the inflammatory nature of the lesion. We present surgical specimens from four patients with multiple sclerosis on whom biopsies were performed because of clinical features mimicking brain tumor. Both general pathologists and neuropathologists involved with these cases experienced difficulty in arriving at the correct diagnosis. In all four cases, the lesions were remarkably uniform in microscopic appearance, consisting of monotonous sheets of gemistocytic astroglia interspersed by numerous foamy macrophages. In sections stained with hematoxylin-eosin, the most helpful diagnostic features were the even distribution of the foamy macrophages and the absence of associated necrosis. In each case, the diagnosis was confirmed with special stains that disclosed total destruction of myelin sheaths with relative preservation of axons. Significant inflammatory infiltration was present in only one of five biopsy specimens.

Adult↗