Journal of clinical neuro-ophthalmology
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J Clin Neuroophthalmol · Dec 1993
Case ReportsRecovery of vision in a 47-year-old man with fulminant giant cell arteritis.
Giant cell arteritis is a systemic necrotizing vasculitis that often causes profound and irreversible visual loss in elderly individuals. We describe a 47-year-old man with fulminant giant cell arteritis whose clinical picture included severe visual loss and several unusual or previously unreported findings. Aggressive treatment with intravenous corticosteroids resulted in a dramatic improvement in the patient's vision. Although no firm conclusions can be drawn from the outcome in a single case, we believe that, in some patients with arteritic ischemic optic neuropathy, aggressive treatment with intravenous corticosteroids may be associated with a better visual prognosis than treatment by the oral route.
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J Clin Neuroophthalmol · Sep 1993
Review Case ReportsConsecutive oculomotor nerve palsy from a de novo cerebral aneurysm.
A 26-year-old woman presented with a partial left oculomotor nerve palsy and an acute subarachnoid hemorrhage. Bilateral angiography showed a left posterior communicating artery aneurysm and a normal right anterior circulation. The aneurysm was successfully clipped. ⋯ New aneurysms may develop from angiographically normal locations. It is possible that certain patients are more susceptible than average to aneurysm formation or that aneurysm repair leads to a higher rate of new aneurysm occurrence. The previous cases of de novo aneurysms are summarized and the implications for repeat aneurysm screening, using current technology, are discussed.
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J Clin Neuroophthalmol · Dec 1992
Review Case ReportsIsolated bilateral abducens nerve palsies caused by the rupture of a vertebral artery aneurysm.
We report two cases with isolated bilateral abducens nerve palsies due to the rupture of a vertebral aneurysm. Surgery revealed that the aneurysm did not directly compress the abducens nerve. ⋯ In view of the clinical and operative findings, it may be regarded as a compression and/or stretching of the bilateral abducens nerves by a thick clot in the prepontine cistern, and not as a manifestation of the raised intracranial pressure. The mechanisms of the isolated abducens nerve palsy are discussed.
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J Clin Neuroophthalmol · Dec 1991
Case ReportsOrbital ischemia, ophthalmoparesis, and carotid dissection.
We report a patient who developed an acute loss of vision in the left eye associated with proptosis, ophthalmoparesis, conjunctival injection, and chemosis. Funduscopy revealed optic disc swelling, and retinal whitening consistent with an ophthalmic artery occlusion. Angiography disclosed bilateral carotid dissections presumably resulting from head trauma 11 days earlier. An orbital ischemic syndrome may be a delayed manifestation of traumatic carotid dissection and precede cerebral hypoperfusion.
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J Clin Neuroophthalmol · Mar 1991
Case Reports Comparative StudyMagnetic resonance angiography (MRA) of isolated aneurysmal third nerve palsy.
Magnetic resonance angiography (MNA) was compared to conventional intra-arterial digital subtraction angiography in a patient with an isolated third nerve palsy caused by a posterior communicating artery aneurysm. The technique of MRA is briefly discussed.