Optic nerve evulsion is a visually devastating and rare manifestation resulting in sudden visual loss after ocular trauma. The several hypothesis of mechanism include penetrating orbital injury causing a backward pull on the optic nerve, extreme rotation and forward displacement of the globe, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. The authors report a case of optic nerve evulsion in a 25- year old man who was struck in the right eye with a umbrella. The diagnosis was made by fundoscopic findings, fluorescein angiography, visual evoked potential, electroretinography, orbit computed tomography and magnetic resonance image.
Diagnosis ; Electroretinography ; Evoked Potentials, Visual ; Fluorescein Angiography ; Intraocular Pressure ; Optic Nerve* ; Orbit ; Rupture

No abstract available.
Diabetic Neuropathies* ; Lumbosacral Plexus* ; Magnetic Resonance Imaging*

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Senile entropion is caused by following pathophysiologic changes ; disinsertion or weakness of lower lid retractor, upward migration and overriding of the preseptal orbicularis oculi muscle over pretarsal orbicularis muscle, horizontal lid laxity, and relative enophthalmos from absorption of orbital fat. There have been numerous procedures to correct senile entropion, but the difficulty of adequate and concurrent correction of all of the underlying defect result in high recurrence rate. Therefore, authors performed a combined procedure including reattachment of disinserted lower lid retractor or tucking of weakened lower tarsus, and the extirpation of overriding preseptal orbicularis oculi muscle. At the same time we performed the correction of the lower lid laxity using lateral tarsal strip procedure of full-thickness wedge resection. Authors performed this method in 21 cases of 17 patients and the cosmetic and functional result were satisfactory.
Absorption ; Ankle ; Enophthalmos ; Entropion* ; Humans ; Orbit ; Recurrence

Pseudotumor cerebri is a syndrome of increased intracranial pressure, and may be a rare complication of cyclosporine treatment. We report a 26-year-old woman with pseudotumor cerebri which developed after cyclosporine medication for kidney transplantation. Regular examinations of the fundi are required in patients taking oral cyclosporine, especially when they report headache or blurred vision.
Adult ; Cyclosporine ; Female ; Headache ; Humans ; Intracranial Pressure ; Kidney ; Kidney Transplantation ; Pseudotumor Cerebri

Thrombotic thrombocytopenic purpura (TTP) is frequently associated with small cortical and subcortical infarcts. However, major intracranial artery occlusion is rare. We report a case of progressive middle cerebral artery (MCA) infarction in a patient with TTP. A 76-year-old woman with hypertension was admitted due to right hemiparesis and transcortical motor aphasia. On laboratory findings, she had microangiopathic hemolytic anemia and thrombocytopenia. Brain MRI showed left subcortical multiple infarction, and MR angiogram revealed severe stenosis of left MCA main stem. She was treated with heparin and steroid but a few days later, there was neurologic deterioration attributed to progressive occlusive stroke in the left MCA territory. Follow-up brain CT demonstrated left malignant MCA infarction. TTP may be associated with progressive occlusion of large cerebral artery.
Aged ; Anemia, Hemolytic ; Aphasia, Broca ; Arteries ; Brain ; Cerebral Arteries ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Heparin ; Humans ; Hypertension ; Infarction ; Infarction, Middle Cerebral Artery* ; Magnetic Resonance Imaging ; Middle Cerebral Artery* ; Paresis ; Purpura, Thrombotic Thrombocytopenic* ; Stroke ; Thrombocytopenia

Chordoid meningioma, an uncommon subtype of meningioma, occurs rarely in the spine. In this case report, the authors present a case of spinal chordoid meningioma in a young female patient, and include a detailed description of imaging findings and a literature review.
Female ; Humans ; Meningioma ; Spine

BACKGROUND AND PURPOSE: Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. METHODS: We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. RESULTS: The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. CONCLUSIONS: Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.
Action Potentials ; Antibodies ; Axons* ; Classification ; Diagnosis ; Early Diagnosis ; Electrodiagnosis ; Guillain-Barre Syndrome* ; Humans ; Medical Records ; Neural Conduction ; Retrospective Studies ; Ulnar Nerve ; Upper Extremity*

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.
Demyelinating Diseases ; Follow-Up Studies ; Neural Conduction ; Optic Neuritis ; Polyneuropathies ; Recurrence

The purpose of this study was to investigate clinical and radiological outcomes of multiple drilling in case of failed conservative treatment of juvenile osteochondritis dissecans in athletes. We treated 37 lesions from 30 athletic patients who failed conservative treatment for juvenile osteochondritis dissecans. Multiple drillings were done for 32 lesions and multiple drilling and bioabsorbable pin fixations were done for 5 lesions. Lysholm score, Hughston clinical scale were used for clinical evaluation before and last follow up of treatment. For radiologic evaluation we used magnetic resonance imaging at 3 months and 12 months after operation. Of all 37 lesions, 11 lesions were located on medial femoral condyle, 2 lesions on lateral femoral condyle and 24 lesions on trochlear groove. There were clinical and radiological improvement from Hughston scale after operative treatment. Twenty-five patients among 30 returned to the sports activity. There were no specific complications after operation. Multiple drilling and bio-absorbable pin fixation of juvenile athletic osteochondritis dissecans patients after failure of conservative treatment showed good clinical and radiologic results. So it would be helpful for juvenile athletic patients to return to sports activities.
Arthroplasty, Subchondral ; Athletes* ; Follow-Up Studies ; Humans ; Knee* ; Magnetic Resonance Imaging ; Osteochondritis Dissecans* ; Osteochondritis* ; Sports