Disorders of cranial nerves

The 12 cranial nerves are peripheral nerves except for the optic nerve which is a central nervous system tract. Disorders of particular note include the following: Olfactory (I) nerve—anosmia is most commonly encountered as a sequel to head injury. Third, fourth, and sixth cranial nerves—complete lesions lead to the following deficits (1) third nerve—a dilated and unreactive pupil, complete ptosis, and loss of upward, downward and medial movement of the eye; (2) fourth nerve—extorsion of the eye when the patient looks outwards, with diplopia when gaze is directed downwards and medially; (3) sixth nerve—convergent strabismus, with inability to abduct the affected eye and diplopia maximal on lateral gaze to the affected side. The third, fourth, and sixth nerves may be affected singly or in combination: in older patients the commonest cause is vascular disease of the nerves themselves or their nuclei in the brainstem. Other causes of lesions include (1) false localizing signs—third or sixth nerve palsies related to displacement of the brainstem produced by supratentorial space-occupying lesions; (2) intracavernous aneurysm of the internal carotid artery—third, fourth, and sixth nerve lesions. Lesions of these nerves can be mimicked by myasthenia gravis....

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III. Contributions to the anatomy of the central nervous system of plagiostomata

Proceedings of the Royal Society of London ◽

10.1098/rspl.1886.0004 ◽

1886 ◽

Vol 40 (242-245) ◽

pp. 10-14 ◽

Cited By ~ 1

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Cranial Nerves ◽

Macroscopic Appearance ◽

Short Account ◽

The Third ◽

Branchial Arches ◽

The Central Nervous System ◽

The Subject ◽

The Difference

After referring to the literature of the subject, the author gives a short account of the macroscopic appearance of the brains of the following species of Plagiostomata, viz., Raja batis, Rhina squatina, Scyllium catulus , and Acanthias vulgaris . He then refers to the distribution of the cranial nerves, especially of the trifacial and vagus, pointing out the resemblance of the distribution of the last-mentioned nerve in Rhina to that described by Gegenbaur in Hexanthus; the difference lying in the fact that in the former the rami branchiales of this nerve, the number of which correspond the number of the branchial arches, divide into two terminal branches only, the rami anteriores and posteriores, the third, the rami pharyngei, being absent.

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METABOLIC STUDIES WITH 131I-LABELED THYROXINE. II.

Acta Endocrinologica ◽

10.1530/acta.0.0440475 ◽

1963 ◽

Vol 44 (3) ◽

pp. 475-480 ◽

Cited By ~ 1

Author(s):

R. Grinberg

Keyword(s):

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Optic Nerve ◽

Pituitary Gland ◽

Time Interval ◽

Time Intervals ◽

Pituitary Glands ◽

The Central Nervous System ◽

Tentative Explanation

ABSTRACT Radiologically thyroidectomized female Swiss mice were injected intraperitoneally with 131I-labeled thyroxine (T4*), and were studied at time intervals of 30 minutes and 4, 28, 48 and 72 hours after injection, 10 mice for each time interval. The organs of the central nervous system and the pituitary glands were chromatographed, and likewise serum from the same animal. The chromatographic studies revealed a compound with the same mobility as 131I-labeled triiodothyronine in the organs of the CNS and in the pituitary gland, but this compound was not present in the serum. In most of the chromatographic studies, the peaks for I, T4 and T3 coincided with those for the standards. In several instances, however, such an exact coincidence was lacking. A tentative explanation for the presence of T3* in the pituitary gland following the injection of T4* is a deiodinating system in the pituitary gland or else the capacity of the pituitary gland to concentrate T3* formed in other organs. The presence of T3* is apparently a characteristic of most of the CNS (brain, midbrain, medulla and spinal cord); but in the case of the optic nerve, the compound is not present under the conditions of this study.

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Early Detection of Central Nervous System Relapse of Pediatric Leukemia with Measurement of Optic Nerve Sheath Diameter on MRI

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666181115114310 ◽

2019 ◽

Vol 15 (2) ◽

pp. 237-241

Author(s):

Taner Arpaci ◽

Barbaros S. Karagun

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Optic Nerve ◽

Early Detection ◽

Optic Nerve Sheath Diameter ◽

Central Nervous System Relapse ◽

Mri Findings ◽

Pediatric Leukemia ◽

Optic Nerves ◽

Cns Relapse

Background: Leukemia is the most common pediatric malignancy. Central Nervous System (CNS) is the most frequently involved extramedullary location at diagnosis and at relapse. </P><P> Objective: To determine if Magnetic Resonance Imaging (MRI) findings of optic nerves should contribute to early detection of CNS relapse in pediatric leukemia. Methods: Twenty patients (10 boys, 10 girls; mean age 8,3 years, range 4-16 years) with proven CNS relapse of leukemia followed up between 2009 and 2017 in our institution were included. Orbital MRI exams performed before and during CNS relapse were reviewed retrospectively. Forty optic nerves with Optic Nerve Sheaths (ONS) and Optic Nerve Heads (ONH) were evaluated on fat-suppressed T2-weighted TSE axial MR images. ONS diameter was measured from the point 10 mm posterior to the globe. ONS distension and ONH configuration were graded as 0, 1 and 2. Results: Before CNS relapse, right mean ONS diameter was 4.52 mm and left was 4.61 mm which were 5.68 mm and 5.66 mm respectively during CNS relapse showing a mean increase of 25% on right and 22% on left. During CNS relapse, ONS showed grade 0 distension in 15%, grade 1 in 60%, grade 2 in 25% and ONH demonstrated grade 0 configuration in 70%, grade 1 in 25% and grade 2 in 5% of the patients. Conclusion: MRI findings of optic nerves may contribute to diagnose CNS relapse by demonstrating elevated intracranial pressure in children with leukemia.

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Glioblastoma infiltration into central nervous system tissue in vitro: involvement of a metalloprotease.

The Journal of Cell Biology ◽

10.1083/jcb.107.6.2281 ◽

1988 ◽

Vol 107 (6) ◽

pp. 2281-2291 ◽

Cited By ~ 68

Author(s):

P A Paganetti ◽

P Caroni ◽

M E Schwab

Keyword(s):

Central Nervous System ◽

Nervous System ◽

White Matter ◽

Optic Nerve ◽

Cell Attachment ◽

Neurite Growth ◽

Cell Spreading ◽

C6 Cells ◽

3T3 Fibroblasts

Differentiated oligodendrocytes and central nervous system (CNS) myelin are nonpermissive substrates for neurite growth and for cell attachment and spreading. This property is due to the presence of membrane-bound inhibitory proteins of 35 and 250 kD and is specifically neutralized by monoclonal antibody IN-1 (Caroni, P., and M. E. Schwab. 1988. Neuron. 1:85-96). Using rat optic nerve explants, CNS frozen sections, cultured oligodendrocytes or CNS myelin, we show here that highly invasive CNS tumor line (C6 glioblastoma) was not inhibited by these myelin-associated inhibitory components. Lack of inhibition was due to a specific mechanism as the metalloenzyme blocker 1,10-phenanthroline and two synthetic dipeptides containing metalloprotease-blocking sequences (gly-phe, tyr-tyr) specifically impaired C6 cell spreading on CNS myelin. In the presence of these inhibitors, C6 cells were affected by the IN-1-sensitive inhibitors in the same manner as control cells, e.g., 3T3 fibroblasts or B16 melanomas. Specific blockers of the serine, cysteine, and aspartyl protease classes had no effect. C6 cell spreading on inhibitor-free substrates such as CNS gray matter, peripheral nervous system myelin, glass, or poly-D-lysine was not sensitive to 1,10-phenanthroline. The nonpermissive substrate properties of CNS myelin were strongly reduced by incubation with a plasma membrane fraction prepared from C6 cells. This reduction was sensitive to the same inhibitors of metalloproteases. In our in vitro model for CNS white matter invasion, cell infiltration of optic nerve explants, which occurred with C6 cells but not with 3T3 fibroblasts or B16 melanomas, was impaired by the presence of the metalloprotease blockers. These results suggest that C6 cell infiltrative behavior in CNS white matter in vitro occurs by means of a metalloproteolytic activity, which probably acts on the myelin-associated inhibitory substrates.

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Unilateral Optic Nerve Leukemic Infiltration and Exudative Retinal Detachment as Initial Manifestations of Central Nervous System Relapse in Acute Lymphoblastic Leukemia of Children

Journal of Clinical & Experimental Ophthalmology ◽

10.4172/2155-9570.1000359 ◽

2014 ◽

Vol 05 (05) ◽

Author(s):

Hsi Kung Kuo

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Acute Lymphoblastic Leukemia ◽

Optic Nerve ◽

Retinal Detachment ◽

Lymphoblastic Leukemia ◽

Central Nervous System Relapse ◽

Exudative Retinal Detachment ◽

Leukemic Infiltration

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Extracranial, Extraspinal Meningiomas of the Head and Neck

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949310201211 ◽

1993 ◽

Vol 102 (12) ◽

pp. 967-970 ◽

Cited By ~ 28

Author(s):

Matthew Kershisnik ◽

David L. Callender ◽

John G. Batsakis

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Aggressive Behavior ◽

Head And Neck ◽

Cranial Nerves ◽

Surgical Excision ◽

Anatomic Site ◽

Arachnoid Granulations ◽

Cell Clusters ◽

Arachnoid Cell

The head and neck is the most frequent location for extraneuraxial meningiomas, be they wholly extracranial or extraspinal or extensions of central nervous system meningiomas. Regardless of anatomic site of origin, nearly all meningiomas arise from meningocytes of arachnoid granulations. Ectopic arachnoid cell clusters have a predilection for areas of dural penetration of cranial nerves, and it is in these areas that most extracranial meningiomas are found. Surgical excision is the mainstay of treatment and must be planned by radiologic studies to determine the extent of the tumor and the presence or absence of a companion central nervous system meningioma. The often locally invasive and aggressive behavior of the meningiomas belies their benign histologic appearance.

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Comparison of clinical, immunological and neuroimaging features between anti-aquaporin-4 antibody-positive and antibody-negative Sjögren’s syndrome patients with central nervous system manifestations

Multiple Sclerosis Journal ◽

10.1177/1352458511431727 ◽

2012 ◽

Vol 18 (6) ◽

pp. 807-816 ◽

Cited By ~ 25

Author(s):

Riwanti Estiasari ◽

Takuya Matsushita ◽

Katsuhisa Masaki ◽

Takuya Akiyama ◽

Tomomi Yonekawa ◽

...

Keyword(s):

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Optic Nerve ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Posterior Column ◽

Aquaporin 4 ◽

Aqp4 Antibody ◽

Sjögren‘S Syndrome

Background and objective: The objective of this study is to clarify clinical, immunological, and neuroimaging features in anti-aquaporin-4 (AQP4) antibody-positive and antibody-negative Sjögren’s syndrome (SS) patients with central nervous system (CNS) involvement. Methods: Medical records and MRI scans were retrospectively analyzed in 22 consecutive SS patients with CNS manifestations. Results: Seven (31.8%) patients were positive for anti-AQP4 antibodies. The frequency of visual impairment was higher in anti-AQP4 antibody-positive patients than in antibody-negative patients (71.4% vs. 0.0%, p = 0.0008). Brain MRI showed that discrete lesions were more commonly found in the cerebrum, brainstem, and optic nerve in anti-AQP4 antibody-positive patients than in antibody-negative patients ( p = 0.002, p = 0.006, and p = 0.004, respectively), while spinal cord MRI showed that posterior column lesions in the cervical spinal cord were more frequent in anti-AQP4 antibody-positive patients than in antibody-negative patients (71.4% vs. 14.3%, p = 0.01). SS-A antibody titers were higher in anti-AQP4 antibody-positive patients than in antibody-negative patients ( p = 0.012) and were also higher in patients with longitudinally extensive spinal cord lesions (LESCLs) than in those without LESCLs ( p = 0.019). Conclusions: In SS, the presence of anti-AQP4 antibodies is associated with involvement of the optic nerve, cerebrum and brainstem, and with cervical posterior column lesions in the spinal cord.

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Pilomyxoid Astrocytoma Occurring in the Third Ventricle

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.161853 ◽

2015 ◽

Vol 5 ◽

pp. 41

Author(s):

Sanghyeon Kim ◽

Myongjin Kang ◽

Sunseob Choi ◽

Dae Cheol Kim

Keyword(s):

Central Nervous System ◽

Nervous System ◽

World Health Organization ◽

Third Ventricle ◽

World Health ◽

Central Nervous System Tumor ◽

Pilomyxoid Astrocytoma ◽

The Third ◽

The Central Nervous System ◽

Health Organization

Pilomyxoid astrocytoma (PMA) is a rare central nervous system tumor that has been included in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. Due to its more aggressive behavior, PMA is classified as Grade II neoplasm by the World Health Organization. PMA predominantly affects the hypothalamic/chiasmatic region and occurs in children (mean age of occurrence = 10 months). We report a case of a 24-year-old man who presented with headache, nausea, and vomiting. Brain CT and MRI revealed a mass occupying only the third ventricle. We performed partial resection. Histological findings, including monophasic growth with a myxoid background, and absence of Rosenthal fibers or eosinophilic granular bodies, as well as the strong positivity for glial fibrillary acidic protein were consistent with PMA.

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The incidence and pathophysiology of neurological symptoms in COVID-19

Russian Military Medical Academy Reports ◽

10.17816/rmmar83617 ◽

2021 ◽

Vol 40 (4) ◽

pp. 33-42

Author(s):

Igor V. Litvinenko ◽

Miroslav M. Odinak ◽

Nikolay V. Tsygan ◽

Aleksander V. Ryabtsev

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Rare Complication ◽

Cranial Nerves ◽

Neurological Symptoms ◽

Immune Mediated ◽

High Incidence ◽

The Central Nervous System ◽

Coronavirus Infection

The central nervous system seems to be quite vulnerable to SARS-CoV-2, leading to a variety of alteration pathways, high incidence and variability of the neurological symptoms of COVID-19. The COVID-19 symptoms, possibly associated with alteration to the central nervous system, include hyperthermia, shortness of breath, fatigue, headache, dizziness, dysphonia, dysphagia, hyposmia and anosmia, hypogeusia and ageusia, impairment of consciousness. The impairment of olfaction and gustation are the most common symptoms of the nervous system alteration (98% and 70%, respectively), which is most likely a consequence of the alteration of the receptors. Presumably the pathogenesis of dysphonia and dysphagia may involve neurodegenerative mechanisms or may be associated with a predominantly demyelinating alteration of the caudal cranial nerves. Pathomorphological findings in the brain of the COVID-19 patients include diffuse hypoxic and focal ischemic injuries of various sizes up to ischemic infarctions (in thrombosis of large arteries); microangiopathy; vasculitis; diapedetic and confluent hemorrhages with possible progression to hemorrhagic infarctions and rarely intracerebral hematomas. Acute cerebrovascular accident worsens the course of COVID-19 and can worsen the clinical outcome, taking into account the mechanisms of the central nervous system alteration in highly contagious coronavirus infections (SARS-CoV, MERS, SARS-CoV-2), including embolism, hypoxia, neurodegeneration, systemic inflammatory response and immune-mediated alteartion to the nervous tissue. A fairly rare complication of coronavirus infection, however, acute myelitis requires attention due to the severity of neurological disorders. The literature data show high incidence and polymorphism of the symptoms of the central nervous system alteration, as well as the important role of the cerebrovascular and neurodegenerative pathogenesis of brain alteration in COVID-19, which is taken into account in examining and treating the patients with new coronavirus infection. (1 figure, bibliography: 61 refs)

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