RESUMEN
The combination of pain, ipsilateral oculosympathetic defect (ptosis and miosis), and ipsilateral trigeminal dysfunction constitutes Raeder's syndrome. We describe a patient with an acute presentation of Raeder's syndrome due to spontaneous internal carotid artery dissection. True trigeminal dysfunction due to carotid dissection is rare, and the potential mechanisms for its involvement are reviewed in this paper. Finally, we remind clinicians to consider dissection in the differential diagnosis of Raeder's syndrome because of its potential for ischemic cerebral neurologic sequelae and suggest early cranial and neck imaging in the evaluation of such patients.
Asunto(s)
Enfermedades de las Arterias Carótidas/complicaciones , Cefalea/etiología , Nervio Trigémino , Adulto , Arteria Carótida Interna , Enfermedades de los Nervios Craneales/etiología , Femenino , Síndrome de Horner/etiología , Humanos , Rotura Espontánea , SíndromeRESUMEN
Increased intracranial pressure may produce a variety of clinical manifestations, some common and others rare. We present a patient with idiopathic intracranial hypertension whose initial symptom was hemifacial spasm. All signs and symptoms of intracranial hypertension resolved with acetazolamide.
Asunto(s)
Músculos Faciales/patología , Seudotumor Cerebral/complicaciones , Espasmo/etiología , Femenino , Humanos , Presión Intracraneal , Persona de Mediana EdadRESUMEN
Efficacy of optic nerve sheath decompression (ONSD) in treating non-arteritic ischemic optic neuropathy (NAION) is not clear. We retrospectively analyzed the records of 91 patients with NAION, who were examined during a two-year period, and compared the final Snellen visual acuities of eyes treated with ONSD with those of eyes that did not have surgery. Seven of 18 eyes with ONSD (39%) demonstrated increased visual acuity of two or more lines; whereas 23 of 71 eyes without surgery (32%) had increased acuity. The ONSD group and no surgery group were further subdivided into eyes with progressive visual loss and nonprogressive visual loss. No statistically significant differences in visual outcome between groups were found. We did not find the high frequency of visual improvement that has been reported in some studies of ONSD for NAION.
Asunto(s)
Isquemia/cirugía , Nervio Óptico/irrigación sanguínea , Nervio Óptico/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Arteritis/cirugía , Femenino , Humanos , Isquemia/etiología , Isquemia/fisiopatología , Masculino , Persona de Mediana Edad , Vaina de Mielina , Nervio Óptico/fisiopatología , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza VisualRESUMEN
Ophthalmoplegia associated with dural carotid-cavernous sinus fistula typically involves the third, fourth, and sixth cranial nerves. Occasionally, isolated palsy of the oculomotor or abducens nerve is noted. We report a patient with bilateral dural carotid-cavernous sinus fistulas who presented with an isolated trochlear nerve palsy.
