ABSTRACT
A heretofore undescribed case of mesencephalic skew deviation in association with a third ventricle colloid cyst is reported. Evidence is provided tha the oculomotor symptoms were caused by irritation of midbrain tegmentum structures, which proved to be critical for vertical eye movements.
Subject(s)
Cerebral Ventricles , Cysts/complications , Strabismus/etiology , Adult , Brain Diseases/complications , Brain Diseases/diagnosis , Cysts/diagnosis , Humans , MaleABSTRACT
The growth of a small arteriovenous angioma over a period of almost 18 years in a 20 year old patient has been proved by arteriography. This case is added to 29 cases previously published in the literature. The authors do not readily accept the theory of autochthonous growth, but prefer secondary or "pseudo-growth". In favour of this there are the following factors: 1. Not all arteriovenous angiomas observed over long periods show growth. 2. There are undoubted haemodynamic circulatory disturbances with turbulence, "wind-pocket effects", and abnormal shunts. 3. After complete removal of an angioma the cerebral circulation becomes normal and there is regression of the dilatation of the feeding and draining vessels.
Subject(s)
Intracranial Arteriovenous Malformations/pathology , Adult , Dilatation, Pathologic , Female , Humans , Intracranial Arteriovenous Malformations/diagnostic imaging , Intracranial Arteriovenous Malformations/surgery , Radiography , Time FactorsABSTRACT
A patient aged 39 years with Wyburn-Mason syndrome is presented. He had an apple-sized intracranial arteriovenous angioma racemosum of the left temporo-medical region, which was inoperable, as it extended to the basal ganglia. It was diagnosed by carotid angiography and by sequential brain szintigraphy. More than 50 retinal arteriovenous anastomoses were observed in the left eye, involving all quadrants and the macular region. Some of these anastomoses were only found by fluorescence angiography. Clinical signs were hemiparesis and decreased sensibility of the right side, headaches, speech disorders and right homonymous hemianopia. Vision was decreased to 0.4. By partial embolisation via the right common carotid, it was possible to reduce the size of the intracranial hemangioma.
Subject(s)
Intracranial Aneurysm/diagnosis , Retinal Vessels , Adult , Eye Neoplasms/diagnosis , Fluorescein Angiography , Fundus Oculi , Humans , Male , Nevus/diagnosis , Radionuclide Imaging , Syndrome , Vision Disorders/etiologyABSTRACT
In a patient with stenosis of the left internal carotid artery acute amaurosis of the left eye was observed after carotid arteriography. The macular branches of the central retinal artery and of the cilioretinal artery were obliterated by embolic material. Two further patients with carotid occlusion and stenosis, in whom spontaneous loss of vision occured, are presented. In such cases the diagnosis may be made with comparable accuracy by other methods, such as ophthalmodynamometry or angioscintigraphy, which entail risk to the patient.
Subject(s)
Blindness/etiology , Cerebral Angiography/adverse effects , Adult , Carotid Artery Diseases/complications , Carotid Artery Diseases/diagnostic imaging , Embolism/etiology , Female , Humans , Male , Middle Aged , Retinal Diseases/etiology , Retinal VesselsABSTRACT
Catamneses of children up to the age of 16, operated on spinal tumours, are reported. Spinal tumours of this age account for about 15% of the total (all ages). There are about 50% intradural and 50% extradural tumours. The most frequent extradural tumours are sarcomas, followed by lipomas and dysontogenetic tumours like teratomas. Intradural tumours consist of intramedullary and extramedullary ones, about 50% each. Intramedullary tumours are gliomas, extramedullary ones may be neurinomas, meningeomas and vascular tumours. Time from onset of first diffuse symptoms up to clinical diagnosis depends on growth tendency of the tumour as well as on its localization. Hence, case history in cases of intramedullary gliomas usually covers two years, of sarcomas only a couple of months. In half of the cases, pain was the first symptom, followed by disturbed motor function. In more than 50% of the cases, complete restoration or significant improvement could be achieved by surgery. In the remaining half, there was either no change or even deterioration of the disturbed function. It seems justified to replace the former pessimistic attitude towards therapy of spinal tumours in childhood by a discret optimism. If in addition other spinal diseases like disk herniation are taken into account, prognosis is even more favourable.
