An Interpretation of Optic Nerve Tortuosity

2009 ◽  
Vol 22 (4) ◽  
pp. 381-385 ◽  
Author(s):  
A. Viglianesi ◽  
M. Messina ◽  
R. Chiaramonte ◽  
G.A. Meli ◽  
L. Meli ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Nerve Palsy ◽  
Visual Loss ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Resonance Imaging ◽  
Optic Nerve Glioma ◽  
Orbital Pain

Magnetic resonance imaging disclosed both optic nerve tortuosity and kinking in a 64-year-old man with orbital pain and monolateral abducens nerve palsy. The association between optic nerve tortuosity and abducens nerve palsy is often described in literature reports of idiopathic intracranial hypertension. However the diagnosis of idiopathic intracranial hypertension was excluded in our patient because of the absence of other signs such as papilledema (universally present in the cases of idiopathic intracranial hypertension), visual loss, headache and flattening of the posterior sclera. Other possible diagnoses to be considered when looking at a case of optic nerve tortuosity are neurofibromatosis and/or optic nerve glioma. Tortuosity of both optic nerves seems to be isolated in our patient and not associated with other diseases or disorders. We suggest that in some patients optic nerve tortuosity could be correlated with an aberrant anatomical development of the optic nerve. Further studies are necessary to confirm this hypothesis which currently remains conjectural.

scholarly journals Lyme disease with erythema migrans presenting concurrently with optic nerve perineuritis and abducens nerve palsy

2020 ◽  
Vol 13 (3) ◽  
pp. e231889 ◽  
Author(s):  
Michael S Lundin ◽  
Sherri L Sandel ◽  
Corina M Suciu ◽  
Debra A Spicehandler
Keyword(s):  
Optic Nerve ◽  
Lyme Disease ◽  
Nerve Palsy ◽  
Erythema Migrans ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy

scholarly journals A rare case of post traumatic isolated bilateral abducens nerve palsy

2014 ◽  
Vol 21 (4) ◽  
pp. 497-499
Author(s):  
Manish Jaiswal ◽  
Saurabh Jain ◽  
Ashok Gandhi ◽  
Achal Sharma ◽  
R.S. Mittal
Keyword(s):  
Rare Case ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Resonance Imaging ◽  
Intracranial Lesion ◽  
Mri Brain ◽  
Post Traumatic ◽  
Magnetic Resonance Imaging Mri ◽  
Bilateral Abducens

Abstract Although unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of traumatic brain injury, bilateral abducens nerve palsy following injury is extremely rare. In this report, we present the case of a patient who developed isolated bilateral abducens nerve palsy following minor head injury. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images & Magnetic Resonance Imaging (MRI) brain demonstrated no intracranial lesion. Herein, we discuss the possible mechanisms of bilateral abducens nerve palsy and its management.

Vascular Compressive Abducens Nerve Palsy Disclosed by Magnetic Resonance Imaging

1996 ◽  
Vol 122 (3) ◽  
pp. 416-419 ◽  
Author(s):  
KENJI OHTSUKA ◽  
AKIRA SONE ◽  
YASUO IGARASHI ◽  
HIDENARI AKIBA ◽  
MOTOMICHI SAKATA
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Resonance Imaging

Optic Nerve Glioma and Optic Neuritis Mimicking One Another: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 57 (1) ◽  
pp. E190-E190 ◽  
Author(s):  
Luis M. Tumialán ◽  
Sanjay S. Dhall ◽  
Valérie Biousse ◽  
Nancy J. Newman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Radiographic Finding ◽  
Acute Onset ◽  
Resonance Imaging ◽  
Optic Nerve Glioma ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: The clinical and radiographic presentations of optic nerve gliomas and optic neuritis are for the most part distinct and their diagnoses straightforward. We present two cases illustrating the occasional difficulty one can encounter in distinguishing neoplastic from inflammatory optic neuropathies. CLINICAL PRESENTATION: Patient 1 is a 17-year-old girl who presented with acute onset of pain and rapidly progressive visual loss in the right eye. Patient 2 is a 38-year-old man who presented with painless progressive visual loss in the left eye. INTERVENTION: Patient 1 was initially diagnosed with idiopathic retrobulbar optic neuritis. Interval increase of the optic nerve on magnetic resonance imaging prompted a biopsy of the optic nerve, which revealed a pilocytic astrocytoma. Patient 2 was found to have left optic nerve enhancement most consistent with an optic nerve glioma. Before a biopsy, the patient spontaneously improved without treatment, indicating an inflammatory process. CONCLUSION: Differentiating between optic nerve neoplasm and inflammation may be difficult. On occasion, the classic clinical finding of pain with eye movement and the radiographic finding of enlargement and enhancement of the optic nerve may be misleading. Open biopsy of the optic nerve is indicated only after a completely negative metabolic, infectious, and inflammatory workup; interval increase of the optic nerve on magnetic resonance imaging; and failure of the patient to recover vision.

scholarly journals Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

2007 ◽  
Vol 23 (5) ◽  
pp. E6 ◽  
Author(s):  
Steven E. Feldon
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Stent Placement ◽  
Idiopathic Intracranial Hypertension ◽  
Visual Loss ◽  
Surgical Techniques ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Visual Outcomes ◽  
Nerve Sheath

Object The object of this study was to compare surgical techniques for management of visual loss in idiopathic intracranial hypertension (IIH) unresponsive to medical treatment. Methods The published literature was reviewed using electronic and manual search techniques. Articles were categorized based upon the surgical procedure performed, including optic nerve sheath decompression (ONSD), also called optic nerve sheath fenestration; intracranial venous sinus stent placement; ventriculoperitoneal (VP) shunt placement; and lumboperitoneal (LP) shunt placement. Demographic data and visual outcome of the cumulative experience were compiled and compared for each type of surgical intervention. Results Seventeen patients treated by stent placement, 31 by VP shunt placement, 44 by LP shunt placement, and 252 patients by ONSD were identified in the literature; average follow-up ranged from 11.8 months for patients treated with stents to 57.2 months for those treated with LP shunts. Improved or resolved vision deficit was noted in 38.7% of patients after VP shunt placement, 47% of patients after stent placement, 44.6% of patients after LP shunt placement, and 80% of eyes after ONSD. Visual worsening was rare for all procedures evaluated. Conclusions There is a paucity of information regarding visual outcomes from intracranial venous stent placement and cerebrospinal fluid diversion procedures. Visual outcomes from ONSD are better documented and appear to be superior to other surgical techniques for management of IIH. Further studies with improved data collection regarding visual outcomes are needed for surgical procedures other than ONSD in order to assess their possible value as treatments for visual loss in IIH.

scholarly journals Ophthalmic Manifestations of Hematopoietic Malignancy

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Natsuyo Yoshida-Hata ◽  
Naomichi Katai ◽  
Toshiyuki Oshitari
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Poor Prognosis ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Hematopoietic Malignancy ◽  
Nerve Invasion ◽  
Hematopoietic Cancer ◽  
Aids Related Lymphoma

Purpose. To report the ocular findings in patients with hematopoietic malignancy with optic nerve involvement and abducens nerve palsy.Methods. The medical records of all cases of hematopoietic cancer with ophthalmic involvements seen in the Department of Ophthalmology of the National Center for Global Health and Medicine between 2009 and 2014 were reviewed.Results. Eight patients with hematopoietic cancer with optic nerve invasion or abducens nerve palsy were studied. The primary diseases were 3 cases of multiple myeloma, 1 case of acute lymphocytic leukemia, 1 case of follicular lymphoma, and 3 cases of AIDS-related lymphoma. Six cases had optic nerve invasion, 2 cases had abducens nerve palsy, and 1 case had optic nerve invasion of both eyes. The median visual acuity of eyes with optic nerve invasion was 0.885 logarithm of the minimum angle of resolution (logMAR) units. The final visual acuity of eyes with optic nerve invasion was 1.25 logMAR units, and that of those with sixth-nerve palsy was −0.1 logMAR units. Six cases died during the five-year follow-up period. An ophthalmic involvement in patients with hematopoietic cancer, especially AIDS-related lymphoma, was associated with poor prognosis.Conclusion. Because ophthalmic involvement in patients with hematopoietic malignancy has a poor prognosis, an early diagnosis of the cancers by the ophthalmologic findings by ophthalmologists could improve the prognosis.

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