Journal of clinical neuro-ophthalmology
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J Clin Neuroophthalmol · Mar 1990
Case ReportsPtosis as the sole manifestation of compression of the oculomotor nerve by an aneurysm of the posterior communicating artery.
Oculomotor palsy secondary to a berry aneurysm is usually present with pupillary dilatation, followed by other signs of third cranial nerve dysfunction, including oculomotor paresis and ptosis. Partial paralysis of the nerve with pupil sparing has been observed, but ptosis as the sole sign of oculomotor paralysis has not previously been reported until now.
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J Clin Neuroophthalmol · Dec 1989
Case ReportsPseudodrusen of the optic disc. Papilledema simulating buried drusen of the optic nerve head.
The distinction between true papilledema and pseudopapilledema rests on characteristics of the optic disc when examined ophthalmoscopically. Buried disc drusen frequently simulate papilledema and often result in misdirected diagnostic maneuvers in search of a cause for presumed intracranial hypertension. ⋯ The lumpy character of the disc border disappeared with resolution of the papilledema, and ultrasonography demonstrated the absence of any buried drusen. Other characteristics of papilledema, including extension of the disc swelling into the peripapillary nerve fiber layer, telangiectasia of the superficial vessels of the optic disc, and obscuration of the retinal vessels as they crossed the margins of the optic disc, provided strong evidence of true papilledema and remain the most reliable findings allowing a distinction between true papilledema and pseudopapilledema.
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J Clin Neuroophthalmol · Mar 1989
Case ReportsMesencephalic hemorrhage and unilateral pupillary deficit.
An isolated dilated and fixed pupil in the absence of other neurological dysfunction usually suggests ciliary ganglion dysfunction or direct pharmacological blockade of the parasympathetic fibers to the pupil. A unilateral dilated pupil as a manifestation of a mesencephalic hemorrhage has not, to our knowledge, previously been reported. ⋯ A cranial computed tomography scan showed a small hemorrhage in the midbrain, and a cerebral angiogram was normal. Mesencephalic hemorrhage should be considered in the differential diagnosis of an isolated dilated pupil.
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J Clin Neuroophthalmol · Dec 1987
Case ReportsChronic asymptomatic ischemic optic neuropathy. A report of two cases in adults with diabetes mellitus.
Two adult diabetic patients with chronic asymptomatic optic neuropathy attributed to an ischemic etiology are reported. In one case the typical syndrome of ischemic optic neuropathy occurred in one eye, while the fellow eye had asymptomatic hyperemic optic disc edema that persisted for 6 months without optic atrophy. ⋯ In the second case, a recent onset, middle-aged diabetic developed bilateral optic neuropathy and optic disc edema that persisted for 12 months, with minimal signs of visual dysfunction. Axoplasmic transport blockage from low-grade ischemia to the optic nerve may cause acute or chronic optic disc edema with minimal or no visual symptoms.
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J Clin Neuroophthalmol · Mar 1987
Case ReportsFourth cranial nerve palsy following spinal anesthesia. A case report.
Fourth nerve palsy has been rarely seen following lumbar puncture, myelogram, or spinal anesthesia. We report a case of 4th nerve and 6th nerve palsies following spinal anesthesia. The 4th nerve palsy was best detected by using a Maddox rod. If all 6th nerve palsies occurring after spinal anesthesia were examined with a Maddox rod, more cyclovertical palsies might be discovered.