Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
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Prone is the preferred patient position for fluoroscopic-guided lumbar puncture (LP). Normative data for cerebrospinal fluid (CSF) opening pressure (OP) exist for lateral decubitus (LD) positioning only and have not been defined for the prone position. This study compares CSF OP values in the prone and LD positions and examines the effect of body mass index (BMI) on OP. ⋯ No statistically or clinically significant difference between prone and LD OP was identified. BMI does not appear to affect CSF OP measurement in either position.
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Cerebrospinal fluid (CSF) leak is an uncommon but well-documented occurrence after blunt head trauma, typically manifesting as otorrhea or rhinorrhea. Blunt cranio-orbital trauma also may cause CSF leak into the orbit, manifesting as orbitocele, blepharocele, chemosis, or tearing ("oculorrhea"). We report a patient who developed oculorrhea after blunt head trauma, and neuroimaging disclosed comminuted fractures of the left frontal, greater sphenoid wing, nasal, and maxillary bones. ⋯ Aspiration of subconjunctival fluid was positive for beta-2 transferrin, a specific marker for CSF. Chemosis lessened and the oculorrhea ceased spontaneously within 6 days of the trauma. This manifestation of CSF leak must not be overlooked because of the threat of meningitis.
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Biography Historical Article
Dr. Airy's "morbid affection of the eyesight": lessons from Teichopsia Circa 1870.
Hubert Airy's iconic drawing of his own migraine visual aura for which he coined the term, "teichopsia," conveys important lessons for the contemporary clinician. His observations of the expansion ("build-up"), minification/magnification, and color/achromatopsia of migrainous teichopsia are consistent with (and possibly anticipatory of) the later discoveries of cortical spreading depression, cortical magnification of primary visual cortex (V1), and specialized cortical centers for color vision.