Holistic processing of faces and words predicts reading accuracy and speed in dyslexic readers

We compared the performance of dyslexic and typical readers on two perceptual tasks, the Vanderbilt Holistic Face Processing Task and the Holistic Word Processing Task. Both yield a metric of holistic processing that captures the extent to which participants automatically attend to information that is spatially nearby but irrelevant to the task at hand. Our results show, for the first time, that holistic processing of faces is comparable in dyslexic and typical readers but that dyslexic readers show greater holistic processing of words. Remarkably, we show that these metrics predict the performance of dyslexic readers on a standardized reading task, with more holistic processing in both tasks associated with higher accuracy and speed. In contrast, a more holistic style on the words task predicts less accurate reading of both words and pseudowords for typical readers. We discuss how these findings may guide our conceptualization of the visual deficit in dyslexia.

GERIATRIC STATUS OF GLAUCOMA PATIENTS

Во многих странах продолжается увеличение заболеваемости первичной открытоугольной глаукомой, а гериатрический статус пациентов ухудшается. В связи с этим актуальным является коррекция гериатрического статуса. Цель исследования - изучение гериатрического статуса пациентов, страдающих ПОУГ, после проведения селективной лазерной трабекулопластики. Результаты исследования базируются на комплексном офтальмологическом и гериатрическом обследовании до и после проведения селективной лазерной трабекулопластики. При изучении гериатрического статуса проведен анализ изменений таких гериатрических синдромов как зрительный дефицит, индекс качества жизни, депрессивный синдром. В ходе исследования установлено позитивное влияние селективной лазерной трабекулопластики на величину снижения зрительного дефицита. Так, острота зрения без коррекции и максимальная корригированная острота зрения после проведенного оперативного вмешательства повысились соответственно с 0,51±0,02 до 0,6±0,01 и с 0,62±0,02 до 0,68±0,01. Однако селективная лазерная трабекулопластика не изменила уровень депрессии, а интегральный показатель качества жизни имел тенденцию к снижению с 438,6±3,9 баллов до 429,4±3,8 баллов. Это указывает на необходимость коррекции гериатрического статуса больных с первичной открытоугольной глаукомой In many countries, the incidence of primary open-angle glaucoma continues to increase, and the geriatric status of patients is deteriorating. In this regard, the correction of geriatric status is relevant. The aim of the study was to study the geriatric status of patients suffering from POAG after selective laser trabeculoplasty. The results of the study are based on a comprehensive ophthalmological and geriatric examination before and after selective laser trabeculoplasty. When studying the geriatric status, the analysis of changes in such geriatric syndromes as visual deficit, quality of life index, and depressive syndrome was carried out. The study found a positive effect of selective laser trabeculoplasty on the reduction of visual deficit. Thus, the visual acuity without correction and the maximum corrected visual acuity after the surgical intervention increased, respectively, from 0.51±0.02 to 0.6±0.01 and from 0.62±0.02 to 0.68±0.01. However, selective laser trabeculoplasty did not change the level of depression, and the integral indicator of quality of life tended to decrease from 438.6±3.9 points to 429.4±3.8 points. This indicates the need to correct the geriatric status of patients with primary open-angle glaucoma

P.156 Outcomes of Cranial Nerve Deficits in Patients with Pituitary Apoplexy: The Ottawa Hospital Experience

Background: One of the rare but urgent presentations of a pituitary tumor is pituitary apoplexy. In this case series, we describe our experience regarding the cranial nerve recovery in patients with pituitary apoplexy following endoscopic endonasal transsphenoidal surgery (EETS). Methods: Retrospective cohort study with patient characteristics, tumor type, endocrine data, operation data collected. Postoperative data were extracted for the follow-up period available for each patient. Results: 15 pituitary apoplexy cases were identified. The cranial nerve deficits presented at admission were: visual deficit (33% patients); unilateral third nerve palsy (47% patients), unilateral sixth nerve palsy (27% patients). Postoperatively, 60% of patients with preoperative visual deficit had normal visual fields and the other 40% showed improvement. From those with oculomotor nerve dysfunction preoperatively, 43% have returned to normal nerve function and 57% presented improvement. 75% cases of abducens nerve palsy resolved postoperatively, while 25% showed improvement. Conclusions: Based on this series, surgical treatment should be offered to patients presenting with cranial nerve deficit in the setting of pituitary apoplexy. In this series, all cranial nerve deficits either returned to normal or improved following surgery. Though a small series, the presented results are superior to those reported in the literature for conservative management.

Dural carotid-cavernous fistulas: our experience with endovascular management

Background Indirect carotid-cavernous fistulas (CCF) are dural arteriovenous fistula of the cavernous sinus and generally present with ocular symptoms. High index of clinical suspicion and radiological work up is required for diagnosis, and treatment is primarily endovascular embolization. We present our experience in diagnosis and management of indirect CCF along with technical evolution to perform embolization and different vascular accesses for difficult anatomy. Results Among a total of 20 indirect CCF cases who were treated with embolization in our department from 2013 to 2020, five (25%) were type C and 15 (75%) were type D. Seven were treated with trans-arterial access only, 11 were treated by transvenous access only, and two were treated by taking both transvenous and trans-arterial access. No recurrence was seen in angiographically cured patients. Out of seven patients who suffered various grades of visual deficit, five recovered completely and two had fixed visual deficit. Third and sixth cranial nerve palsy persisted in two patients even after CCF embolization. Conclusion Indirect CCF is a treatable cause of troublesome ocular symptoms. Endovascular embolization is preferred treatment with excellent short- and long-term outcome. The embolization becomes difficult and challenging in cases where the conventional vascular access to the cavernous sinus is occluded.

875 Use of Oriented Priors Through Magnetic Tractography (MAGNET) In Deliniation Of Meyer's Loop and Correlation with Visual Field Deficit In Temporal Lobe Epilepsy (TLE) Surgery: A Pilot Study

Introduction Pre-operative white matter tract reconstruction of the Meyer’s loop (ML) of the optic radiation using diffusion MRI (tractography) can be used to prevent post-operative visual-field deficit. Due to its complex anatomy, precise reconstruction of the ML is challenging and often underestimated. Previous work has suggested that an innovative tractography technique using oriented priors called MAGNET better approximates reconstruction to reported histological prosections. This proof-of-context study validates the MAGNET methodology in predicting visual-field deficits in patients undergoing TLE surgery. Method Diffusion MRI datasets were used to reconstruct pre-operative ML using MAGNET in five patients. These were overlaid on post-operative T2-MRI series demonstrating the surgically resected area to measure overlap between resection and reconstructed ML. A correlation with post-operative visual-field defects was established. Results There was no evidence of visual field deficit in the cases where there was no overlap between the reconstructed ML and the resected region. In the cases with overlap with reconstructed ML and resection, there was visual deficit found. There was no correlation between proportion of resected ML and visual deficit. Conclusions This pilot demonstrates that MAGNET accurately reconstructs ML in pre-surgical TLE cases compared to standard tractography techniques and can be used to augment neurosurgical planning and resection.

Sudden onset peripheral visual deficit secondary to retinal artery spasm in Raynaud’s phenomenon

A 32-year-old doctor, who has a medical history of primary Raynaud’s disease and previous scotomas, presented to eye clinic with sudden onset blurring of vision (infero-nasally) with no other associated symptoms. The patient had good visual acuity bilaterally (6/6) and no anterior chamber activity or conjunctival hyperaemia. Findings consistent with a nerve fibre layer infarct were noted in the right eye, with unremarkable examination of the left eye. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images were obtained, which showed an area of capillary shut down in keeping with a nerve fibre layer lesion. Previous literature pertaining to similar symptoms is sparse with symptoms such as migraines, epilepsy and visual loss being stated. This case provides further evidence of Raynaud’s associated retinal artery spasm, with complete resolution at 4 weeks. We also demonstrate the accessibility of OCT and more importantly OCTA for investigation of sudden onset visual deficit.

Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series

Background Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification. Design Present study is a single-institution retrospective cohort. Methods A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient. Results Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery. Conclusion In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients.

Cenurosis in a Sheep with Neurological Signs - Diagnosis with Computed Tomography

Background: Cenurosis is a parasitic disease caused by Coenurus cerebralis, an intermediate form of Taenia multiceps multiceps, causing a fatal disease in production animals. Its adult form (Taenia) lodges in the small intestine of canids and can infect several intermediate hosts.Sheep are the main species affected by the disease, having nervous symptoms as one of its manifestations.This study aimed to describe the changes observed in computed tomography, as well as the clinical findings of a case of Cenurosis in a sheep on the western border of Rio Grande do Sul.Case: A ram was referred to the Centro Universitário da Região da Campanha (URCAMP) with neurological signs.Clinical, hematological, radiographic, tomographic and necroscopic evaluation of the animal was performed.There were no significant hematological and radiographic changes.During the neurological examination, corneal opacity was found in the right eyeball, associated with a visual deficit in the same eye.Also, when stimulated to move, it was possible to observe ataxia with ambulation to the left side, with right lateral displacement of the head.The tomography showed a hypodense area of approximately 3 cm at the base of the brain, in the region of the thalamus and third ventricle.Macroscopically, a translucent spherical cyst with approximately 4 cm in diameter was observed, containing the protoescolex/scolices of Taenia multiceps in the same region.Discussion: Computed tomography identified the presence of an apparently circular volume of approximately 4 cm in diameter, causing ventricular dilatation.This evidence of ventricular dilation corroborates aspects described in the literature, which found bilateral dilation of the ventricles by compression promoted by a cyst in the 4th ventricle.As the location of the cyst was located at the base of the brain, in the region of the third ventricle, it would be difficult to perform the surgery in the treatment of this case.Signs of ataxia, walking movements, decreased reflexes, nystagmus, unilateral blindness and lateral decubitus are commonly observed.Reports described that the main neurological alterations observed in 20 sheep with cenurosis were postural deficit, locomotion alteration, visual deficit and behavioral alterations, with more than 50% of the animals showing at least one of these signs.The main neurological signs observed in the case described were changes in gait, with walking, blindness, lateral head deviation and ataxia. These signs guide the clinical diagnosis of cenurosis.At necropsy, a spherical translucent cyst with approximately 4 cm in diameter was observed, containing the protoescolex/scolices of Taenia multiceps, which extended dorsally from the third ventricle to the base of the thalamus, laterally displaced to the right side.Rostrocaudal the lesion extended rostrally across the entire length of the thalamus to the beginning of the caudate nucleus and caudally to the base of the caudal colliculus, causing compression of the adjacent parenchyma, enabling the diagnosis of cenurosis.Similar findings are described as Coenurus cerebralis. This lesion pattern macroscopically characterizes the parasite lesions.Thus, it is concluded that the visualization of a hypodense area in CNS regions of sheep with neurological signs allows the diagnosis of cenurosis and precise location of the lesion.The description of this case adds information so that other professionals in the field can be successful in diagnosing the disease.Keywords: parasitologia, Taenia multiceps multiceps, Coenurus cerebralis, ovelhas, torneio verdadeiro.Descritores: parasitology, Taenia multiceps multiceps, Coenurus cerebralis, sheep, true tournament.Título: Cenurose em ovino com sinais neurológicos - diagnóstico com tomografia computadorizada.

The Role of the Transorbital Superior Eyelid Approach in the Management of Selected Spheno-orbital Meningiomas: In-Depth Analysis of Indications, Technique, and Outcomes from the Study of a Cohort of 35 Patients

Objective Primary goal in spheno-orbital meningioma (SOM) surgery still remains complete resection. Nevertheless, given their highly infiltrative nature, a growing body of literature suggests to shift toward function-sparing surgeries. We here present our experience in the management of SOMs through the endoscopic superior eyelid approach (SEA). Methods Surgical database from our multidisciplinary work group was retrospectively reviewed to identify patients treated for SOMs in the last 10 years by our senior authors, analyzing and correlating clinical, radiological, and outcome variables among the different approaches used. Results There were 35 patients (mean age of 57.3 ± 12.86 years), with a mean follow-up of 31.5 months (range: 6–84 months). The most common preoperative complaint was proptosis (62.9%) followed by diplopia and visual deficit. Greater and lesser sphenoid wings were the areas mainly involved by the pathology (91.4% and 88.6%, respectively), whereas orbital invasion was evidenced in one-third of cases. Patients were operated on through craniotomic (48.6%), endoscopic superior eyelid (37.1%), and combined cranioendoscopic (14.3%) approaches. Simpson grades 0 to II were accomplished in 46.2% of SEA and 76.5% of craniotomies. All patients with a preoperative visual deficit improved in the postoperative period, independently from the approach used. On patients who underwent endoscopic SEA, there was improved their short-/long-term postoperative Karnofsky Performance Status. Conclusions Endoscopic SEA is a safe and effective alternative to transcranial approaches in very selected cases of SOMs, where the planned primary objective was to obtain a maximally safe resection, aimed at symptom relief, rather than a gross total resection at any cost.