Ординатура / Офтальмология / Английские материалы / Neuro-Ophthalmology_Kidd, Newman, Biousse_2008

Ptosis

cause of, 32

and diplopia, 318 Pulfrich phenomenon, 145 Pulsatile proptosis, 60–63

Pulsatile tinnitus, auscultated, 286 Pulsatility, 286

Pupil

abnormal, 265, 269–270

with bilateral symmetrical lesions, 276 bright light to assess, 31

briskness and extent of, 265–267 constriction of, parasympathetic pathway,

19–20

degree of attenuation of, 277 diaphragm in eye, 264

dilation of, oculosympathetic pathway, 20–22 examination of, 30–32

failure of, 269

in Horner’s syndrome, 270–271 normal direct and consensual, 267f pharmacologic dilation of, 38 pharmacology of, 269

reflex dilation of, 268–269 responses to light stimulus, 275f under resting conditions, 265 size of, 30, 264

Pupillary abnormalities, in coma, 40 Pupillary disorders

abnormal, 277–278

lesions in midbrain, 277–278 lesions of visual pathway, 276–277 lesions within eye, 270 parasympathetic lesions, 273–276 sympathetic lesions, 270–273

afferent, 30–31

grading scheme for afferent, 30–31 normal, 264–269

Pupillary miosis, 270 degree of, 267–268 origin of, 277–278

Pupillary pathways, anatomy of, 20–22 Pupillary reflex pathways, diagram of, 21f Pupil light reflex, neural pathways underlying,

266f

Pupillovisual dissociation, 277

Pupil signs, with ipsilateral tendon, 275–276 Pupil size and arousal, relationship between,

268–269

Pursuit eye movement, smooth, 34f Pursuit system, 19

Pyogenic abscesses, 253

R

Radiation, in non-coplanar fields, 220 Radiation optic neuropathy, an ischemic

disorder of, 130

RAPD. See Relative afferent pupillary defect

Rathke’s cleft cysts, 248 sharing, 249

variant of, 249

with visual loss, 248f

Rathke’s cleft elements, of primitive stomatodeum, 238–239

Reading cards, 24 Rectus muscle

superior and inferior, 11

vascular dilatation and swelling overlying, 82f Red bottle tops, 27

Red glass test, an analogous to Maddox rod test, 37–38

Redilatation lag, 270–271 Refractive errors, 23f Refsum’s syndromes, 316 Reiter’s syndrome, 180

Relative afferent pupil defect (RAPD), 264, 267, 276

clinical detection of, 277

with lesions of retina or optic nerve, 276 Renal cell carcinoma, 227

Residual symptoms, 145 Residual visual symptoms, 146

Retention mucoceles, from ethmoidal and frontal paranasal sinuses, 75

Retina

cellular layer of, 2–3 disorders of, 4

and fundus, structures of, 2 inner layers of, 51

ocular manifestations in, 178 and optic nerve

anatomy of, 2–4 blood supply to, 3–4

Retinal arterial attenuation, 191 Retinal artery, and vein occlusion, 178 Retinal artery occlusion, 104t

embolic inferior branch, 104f superior branch, 53f

with visual loss, 105f, 299 Retinal bleeding, with subarachnoid

hemorrhage, 41–42

Retinal degenerations, 54–56, 202–203 Retinal detachment, 53–54

retinovascular occlusion and, 51–54 Retinal dysfunction, with visual field

abnormality, 56 Retinal electrophysiology, 44 Retinal emboli, 99

Retinal fluorescein angiography, 126f Retinal ischemic syndromes, with

neovascularization, 166–167 Retinal migraine, 102

Retinal vein occlusion central, 212f impending central, 97f

with optic nerve head swelling, 53f Retinal vessels, sheathing of, 138

Retino-geniculo-cortical projection, 265–267 Retinopathy, with vitreous hemorrhage, 221 Retinovascular occlusion, and retinal

detachment, 51–54

Retraction nystagmus and Collier’s sign, 277 Retrobulbar idiopathic optic neuritis, 45, 57 Retrobulbar masses, on gaze evoked amaurosis,

63–64

Retrobulbar optic nerve, infiltration of, 228 Retrochiasmal visual pathways

anatomy of, 9–10

lateral geniculate nuclei (LGN), 9 occipital lobes and calcarine cortex, 9–10 optic radiations, 9

optic tracts, 8–9 disorders of, 10–11

lateral geniculate nuclei lesions, 10 occipital lobe lesions, 10–11

optic radiation lesions, 10 optic tract, lesions of, 10

Retrogeniculate lesions, 276–277

Reversible acetylcholinesterase inhibitor, 317 Rhabdomyosarcoma

and neuroblastoma, malignancies of, 89 rapidly growing mass of, 89f

with symptoms and signs of inflammation and swelling, 89f

Rheumatoid arthritis, 80 optic neuropathy in, 180

Riddoch’s phenomenon, 11, 336

Right upper retraction, surgical correction of marked, 88f

riMLF. See Rostral interstitial medial longitudinal fasciculus

Rosai-Dorfman disease, 255, 321 Rosenbaum hand held card, 24, 24f Ross syndrome, 275–276

Rostral interstitial medial longitudinal fasciculus (riMLF), 323

Ruler, to measure eyelid function, 32f

S

Saccade system, 18

fast eye movements, 33 testing, 33f

Saccadic eye movements, in frontal eye fields, 18 Saccadic intrusions, spectrum of, 327–328 Sarcoid, manifestations of, 167

Sarcoidosis

affect anterior visual pathways, 168–169 of eye, 166f

hypertrophic pachymeningitis with, 180f an inflammatory disorder, 165

Sarcoid vitritis, 166–167

SCA. See Spinocerebellar ataxia Schwannoma, 251

benign tumors, 223 of fourth nerve, 320 of optic nerve, 223

Sclera, appearance of, 35

Scleroderma, CREST syndrome and, 180 Sebaceous carcinoma, 92–93

Secondary tumors, 228–231 Seesaw nystagmus, 327

Sella and parasellar region, disorders of, 252 arachnoid cysts, 252

diagnosis of tumors and lesions in, 242t endocrine presentation and investigation,

239–240

headache and intracranial pressure, 241–242 incidental discovery, 242–243

infections and inflammations, 254–255 hypophysitis, 253–254

Langerhans cell histiocytosis, 254–255 metastatic tumors, 252–253

overview, 238–239 tumor types, 250–252

chondrosarcomas, 250–251 chordomas, 251 craniopharyngiomas, 249 germinomas, 251–252 meningiomas, 247–248 optic nerve gliomas, 250 pituitary adenomas, 244–245 Rathke’s cleft cysts, 248 Schwannomas, 251

vascular lesions, 256

visual symptoms and measurement, 240–241 Sella epidermoid, with variable headache, 253f Sella/pituitary fossa, optic chiasm above, 8 SFR. See Stereotactic fractionated radiotherapy SIADH. See Syndrome of inappropriate

antidiuretic hormone Sinus mucocele, 165

Sixth nerve palsy, 16–18, 321

within cavernous sinus, 13f, 17–18 Sjo¨gren’s syndrome, 80, 172–173, 179 Skew deviation, 324

Skin cancers, 226 Sloan charts, 26, 26f

Snellen acuity, accuracy of, 24 Snellen chart, 66, 241 Snellen optotypes, 313

Soft masses, with eyelid swelling, 66–67 Soft tissue, component of tumor, 217–218 Soft tissue mass, 91–92

Somatostatin receptors, discovery of, 72 Space-occupying lesions, 302 Sphenoidal wing meningioma, 65f Sphenoid sinus, mucoceles in, 253 Sphenoid wing, extensive tumors of, 246 Sphenoid wing meningioma

with hyperostosis of sphenoid wing, 88 soft tissue tumor, 88

Sphincter muscle, 265, 273 Spinal fluid pleocytosis, 149

Spinal tumors, cause papilledema, 302 Spinocerebellar ataxia (SCA), 201–202

Spinocerebellar degenerations, 323–324 Squamous carcinoma, 92–93

Standard tests, for color vision, 348 Stephen’s syndromes, 316 Stereopsis

disorders of, 339–340 impaired, 340

loss of, 145 physiology of, 339–340

Stereotactic conformal linear accelerators, 245 Stereotactic fractionated radiotherapy (SFR), 220

acute effects of, 221 complex planning, 220

ophthalmic complications of, 221 Stereotactic radiotherapy series, summary of

primary, 222t

Steroids, in optic neuritis, 148 Steroid taper, rate of, 127 Strawberry nevus, 76–77 Stroke

factors for, 109

neuro-ophthalmic manifestation of, 183 Stroke and cardiovascular events, prevention of,

in patients with TMVL, 108t STS. See Superior temporal salcus Subacute ataxia with nystagmus, 169f

Subarachnoid space, third nerve within, 14–15 Subconjunctival lymphoma, appearance of, 70f Subretinal neo-vascularization with papilledema,

296

Sub-Tenon’s space, 71–72

Subtler hemianopia, checking for, 28f Sulfa allergy, 296

Superior temporal sulcus (STS), 341–342 Supersensitivity, an enhanced response to

receptor agonist, 269

Supranuclear eye movement, abnormalities, 323 Supranuclear, internuclear, and vestibulo-ocular

gaze pathways, anatomy of, 18 Supranuclear palsy, progressive, 323–324 Surgery, for cavernous sinus tumors, 248 Swelling, to nasal margin, 284

Swinging flashlight test, 30–31, 31f Swollen disc, with visual loss, 161f

Syndrome of inappropriate antidiuretic hormone (SIADH), 240

Syndrome of Leigh, 202–203 Syphilis, serologic tests for, 141

Systemic diseases, with NAION, 117–120 Systemic lupus erythematosus, 172–173 Systemic steroids, use of, 81–82

T

Tabes dorsalis, cause for, 277–278 Taches de bougie, 166–167 “tadpole” pupil, example of, 273f Takayasu arteritis, 100

Tangent screen testing, 29, 29f

Temporal artery biopsy, for definitive diagnosis, 127

Tenderness, with acute dacryoadenitis, 66–67 Tensilon test, 37

Terson’s syndrome, 40, 41–42, 47–48

in with ruptured anterior communicating aneurysms, 8

Tetracycline and minocycline, 303 Thalamus, LGN of, 9

Third cranial nerve, 11–12

Third nerve fascicle, lesions of, 319 Third nerve nucleus

lesions of, 15 localizing, 15

Third nerve palsy, 16, 319

acute, painful, pupil-involving, 13–14 Thrombocytosis, 126

Thyroid antibody, prevalence of, 172

Thyroid eye disease, 32–33, 59, 70–71, 80, 82–88 asymmetrical, 68f

characteristics of, 84t CT changes with, 85t

extraocular muscles from, 315f with multiple muscles, 85f and myasthenia gravis, 37

right-sided orbital decompression for, 87f scales for assessing, 86–87

Thyroid ophthalmopathy, 315 Thyroid-stimulating antibody, 315 Thyroid-stimulating hormone (TSH), 70–71, 239 Tissue biopsy, orbital infiltrative disease, 72–73 TMVL. See Transient monocular visual loss Tobacco and alcohol, possible role for, in visual

loss, 198

Tolosa Hunt syndrome, 321 Tonic pupil

bilateral and symmetrical, 275 unilateral, 275

Toxicity late, 220

vasculitis and radiation, 102 Toxic retinopathy, causes of, 56

Traditional testing, for visual object agnosia, 348–349

Transcranial magnetic stimulation (TMS), 335 Transient ischemic attack (TIA), cerebral

hemispheric, 103–104 Transient monocular visual loss (TMVL)

with atheromatous stenosis, 99f carotid endarterectomy, 108–109 cause of, 95–96, 102 characteristics of, 98

diagnosis, 106–107 ancillary studies, 106–107 history, 105–106

ophthalmic examination, 106 differential diagnosis of, 95t with Horner’s syndrome, 107f

and Internal Carotid Artery Stenosis, 109t

374 Index

Transient monocular visual loss (TMVL)—Cont’d mechanisms of, 98–102

ocular conditions, 95–97 vascular arterial ischemia, 102

natural history of, 104, 104t

cerebral hemispheric stroke, 103–104 death, 104

retinal stroke, 103 orthostatic, 95–96

other measures, 109–110

for systemic arteriosclerosis, 104 treatment, 109–110

Trauma, 38, 270 Triple-dose gadolinium, 143 Tritanopia, 199

Trochlear nerve, 15, 319–320 supply superior oblique, 12f

True disc swelling, 281 diagram of, 282f ophthalmoscopic features of,

281–283

True papilledema, 284

TSH. See Thyroid-stimulating hormone TSH-secreting adenomas, causing high TSH

thyrotoxicosis, 239 TSH-secreting tumor, 243–244 Tuberculosis, of hypophysis, 254f

Tumor and tumor-associated changes, MRI on extension of, beyond optic nerve, 208

Tumor cells, power of, 224f Tumors

composed of ganglion cells, 211–212 consistency of, 244–245

diagnosis of, 206, 242t between nerve substance, 215 within optic canal, 219

of optic nerve, 206

relationship of, to dural sheath, 224f in siblings, 207

silent, 243–244

Twin peaks papilledema, 290, 291f Type A personalities, 48–49

U

Uhthoff phenomenon, 145

Ulcerative colitis, and Crohn’s disease, 177 Ultrasonography, 71–72

Unilateral papilledema, 290 Urinary calcium excretion, 168 Uveal melanoma

with orbital extension, 92–93 primary, 92–93

Uveal tract, anterior, cysts or tumors of, 270 Uveitis

anterior, 166 chronic, 166

confined to anterior chamber, 166 signs of, 165–166

V

V1 lesions, 336–337 Variation

with arterial pulsation, 66 with Valsalva maneuver, 66

Varices/lymphangiomas, low-flow vascular lesions, 77–78

Vascular anomalies, of orbit, 76–80

Vascular arterial TMVL, mechanisms responsible for, 98

Vaso-obliterative diseases, 63–64 Vaso-occlusive ischemic retinopathy, 179 Vasospasm, 108

Venous occlusion, 166–167 Venous pressures

and cardiopulmonary disease, 303 and intracranial hypertension, 303

Venous sinus stenting, 299 Venous stasis retinopathy, 101f Venous thrombosis, excluding, 289 VEP. See Visual evoked potentials Vertical deviation, examine, 36–37

Vertical semicircular canals, vestibulo-ocular connections from, 20f

Vestibular imbalance, nystagmus from, 326

Vestibular ocular reflex (VOR), 33, 39–40 cancellation of, 33

defective, 33 Vestibulo-ocular system, 19

Viral, bacterial, and fungal infections, caused optic neuritis, 155t

Viral disorders, 154–155 Viral infections

neurologic and ophthalmic complications of common, 156t

with neuro-ophthalmic complications, 155

Virchow-Robin sheaths, 173 Visible drusen, 287f

Vision

anatomy and physiology of, 333–336 neurophysiology of early, 333–334 obscurations of, 216

physiology of, 335 Vision loss, 128

Visual acuity, 193, 199, 241 abnormal, 23–24

assessment of, 23–24, 220–221 and color vision, 50–51 method of testing, 23–24 relationship of, 144t

Visual agnosia apperceptive, 340 associative, 340–341

Visual association areas, in occipito-temporal and occipito-parietal regions, 9–10

Visual attributes, disorders of, 343–344 Visual development, assessment of, 64

Visual disorders evaluating functional, 29 negative, 337–344

Visual distortions, maculopathy cause, 48 Visual dysfunction, 195

Visual evoked potentials (VEP), 141, 207 in asymptomatic eye, 141

principle use of, 141–142

Visual failure, recurrences of, 194–195 Visual field defects, 7, 161, 163, 193

abnormality, types of, 287–288 assess, 30

characteristics of, 8

with disorders of cortical function, 29 inferior, 113–114

nonexpansion of, 29 of optic neuropathy, 48 retrochiasmal, 11

summary of, in optic neuritis treatment trial, 139f

superior, 113–114 Visual field gems, 30t

Visual field loss, caused by retinal disorders, 4 Visual fields

assessment of, 287–288 with DOA, 199 investigating, 241

recorded in chart from patient’s perspective, 28f

Visual field testing, 27–29

with confrontation technique, 28f, 348 Visual function, 277–278

Visual hallucinations, 333, 346–347 in blind hemifield, 11

onset of, 347

Visual illusions, 333, 345–346 Visual impairment scale, graded, 145

Visual information, retinotopic organization of, 2–3

Visual loss, 299

acute and temporary, 94 in acute leukemia, 231 acute phase of, 194

in amblyopic patients, 24 in arteritic AION, 121–124 caused by optic nerve, 45 causes of, 45–46, 48–49 characteristics of, 106

complication of papilledema, 294 degree of, 169–170

differential diagnosis of, 48 and disc edema, 119f

duration of progression of, 193 feature of papilledema, 280 genetic factors role in, 296 history of, 198

and hydrocephalus, 250f incidence of, 192–193

Index 375

Visual loss—Cont’d

from Leber’s hereditary optic neuropathy, 193f, 194–195

monocular or binocular, 94–95 and ocular motility disorders, 2 onset of, 114, 199

from optic neuropathy, 44 pattern of, 211 perioperative, 128

setting of, 127

Visual object agnosia, 332–333, 340

Visual pathway and visual field defects, lesions of, 6f

Visual recovery, prognosis for, 165 Visual search training, 350

Visual system, anterior, low-grade gliomas of, 210–211

Visuomotor ataxia, 344

Visuospatial function, disorder of, 343–344 Vitamin A deficiency retinopathy, 56 Vitamin B12 deficiency, 326

Vitreal hemorrhages, 47–48 Vitreous cells, 138

Vitreous hemorrhage, 46, 47–48 with Terson’s syndrome, 48f

Vitreous opacities, 160

VKH. See Vogt-Koyanagi-Harada Vogt-Koyanagi-Harada (VKH) syndrome, 177 Von Hippel-Lindau disease, evidence of, 214 VOR. See Vestibular ocular reflex

W

Water stimulation, warm, 39–40 Weber’s syndrome, 15

Wegener’s granulomatosis, 60, 63–64, 69–70, 80, 154, 181–182, 321

giant cell arteritis and, 163 Wernicke’s encephalopathy, 326 Whipple’s disease, 160, 325 Wilbrand’s knee, 5f, 7–8

Wilson’s disease and lipid storage diseases, 323–324

Wolfram’s syndrome, 196f, 201 hallmark of, 201

with mitochondrial diseases, 201 World Health Organization, subtypes,

245–247

Worsening diplopia, 313–314

X

Xerostomia and xerophthalmia, 179

Z

Zygomatico-frontal suture, superotemporal dermoid with, 74f

Zygote, nuclear portion of, 195–196