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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a survival patient with hemorrhage in the quadrigeminal plate and discuss the literature of midbrain hemorrhage. A 13-year-old boy developed severe headache and vertigo on April 1st, 1983. On admission, he was comatose and tetraplegic with bilateral facial palsy and total ophthalmoplegia. CT scan revealed a hemorrhage in the midbrain and ambient cistern, but vertebral angiogram no abnormal vessels. Seven hours after admission, continuous ventricular drainage was performed. Disturbance of consciousness, ophthalmoplegia and speech disturbance were gradually improved. CT scan with contrast medium 3 weeks after admission showed a small high density spot in the right quadrigeminal plate. It might be suggested that this spot was the bleeding point and was probably a cryptic microvascular malformation. At the discharge only a minimal limitation of eye ball movement was left.
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PMID:[Hemorrhage in the quadrigeminal plate--a case report]. 332 Aug 3

We report a case of bilateral intracavernous giant aneurysms of which the right side was clipped by direct surgery. Our case was a 74-year-old woman who developed bilateral abducens palsy. Computed tomography and angiography showed bilateral intracavernous giant aneurysms. This patient was followed up in the outpatient clinic. She developed headache and right trigeminal neuralgia 2 years later. The trigeminal pain was quite severe and very disturbing to her. Repeat angiography showed an increase in the size of the aneurysms. An operation was carried out after a balloon Matus test monitoring electroencephalogram, somatosensory evoked potential, and clinical symptoms. The cavernous sinus was opened and the aneurysm was clipped. There was no postoperative complication except right ophthalmoplegia which resolved after 3 months. Headache and trigeminal neuralgia also disappeared.
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PMID:Bilateral giant intracavernous aneurysms. Technique of unilateral operation. 333 38

Intracranial aneurysms arising in the region of the cavernous carotid artery are difficult to manage surgically because of the surrounding cavernous sinus. With recent advances in microballoon technology and permanent solidification agents, it is now possible to treat certain intracranial aneurysms by detachable balloons and preserve the parent vessel. A patient with Marfan's syndrome presented with severe retroorbital pain, ophthalmoplegia, and headaches. Cerebral angiography demonstrated a large cavernous carotid artery aneurysm measuring 17 X 9 X 6 mm. This was successfully treated by placing three detachable balloons within the aneurysm and preserving the carotid artery via a transvascular approach. Intravascular detachable balloon embolization may offer a form of alternative therapy for the management of surgically difficult aneurysms.
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PMID:Cavernous carotid artery aneurysm associated with Marfan's syndrome: treatment by balloon embolization therapy. 335 78

A 61-year-old woman is presented with a bilateral total ophthalmoplegia as an initial ocular symptom, caused by a midbrain hematoma. She complained of acute headache, nausea, vomiting and bilateral closure of her eyelids. Examination on admission showed meningeal irritation; mild consciousness disturbance; bilateral total ophthalmoplegia; left hemiparesis; ataxia in all extremities, more marked to the left. Computed tomography demonstrated a small hematoma in the midbrain tegmentum. Angiography demonstrated midbrain arteriovenous malformation, and she was treated conservatively. Abduction of both eyes and adduction of the left eye appeared on the next day of the ictus, and after that, improved gradually. Left ptosis had improved since one week after the ictus. Light reflex of the left pupil had seen 5 days after the ictus. At the same time, the left pupil revealed an oval-shape. Right internal ophthalmoplegia continued to exist. One year later, the right eye deviated externally, and the left deviated inferio-medially. Abduction of both eyes was normal. Infraduction of both eyes was seen, but limited on the left. Upgaze paresis remained unchanged, and adduction of the right eye was absent. Adduction of the left eye showed almost full recovery. There was right complete ptosis, but left ptosis became indefinite. These ocular findings indicated typical right oculomotor paresis plus superior rectus paresis of the left eye, which suggested a destructive lesion in the right oculomotor nucleus. Also, her left extremities showed a hemiparesis as a pyramidal tract sign (Weber's syndrome) and an ataxia as a cerebellar sign (Claude's syndrome).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Midbrain arteriovenous malformation causing bilateral total ophthalmoplegia as an initial ocular symptom--a case report]. 337 Jan 70

A case of ophthalmoplegic migraine with cerebral aneurysm is reported. A 47-year-old female with a 17-year history of migraine was admitted. She had three attacks of severe migrainous headache accompanied with nausea and vomiting within three weeks. Soon after the third attack, she noticed diplopia and left blepharoptosis. Lumbar puncture revealed no hemorrhage but the cerebral angiogram demonstrated an aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. Operation revealed that the oculomotor nerve was not compressed by the aneurysm. But the oculomotor nerve had an indentation produced by the posterior communicating artery at 1-2 mm distal to the midbrain. A piece of sponge was then inserted between the nerve and the responsible artery. After the operation, her oculomotor nerve palsy was gradually improved and she discharged with mild anisocoria. The exact pathogenesis of ophthalmoplegia in ophthalmoplegic migraine is still unknown. In our case, cross compression of the oculomotor nerve with dilated posterior communicating artery seemed to be the cause of ophthalmoplegia.
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PMID:[A case of ophthalmoplegic migraine with cerebral aneurysm]. 339 4

A 29-year old female patient suffering from severe pain in her right eye, headache, ophthalmoplegia and ptosis of the right eye, total roentgenological opacity of the right maxillary sinus and ethmoidal cells , as well as signs of bone destruction in the orbital floor, was operated on under the suspicion of a tumour. Histological and bacteriological examinations as well as fungus cultures indicated, however, that the patient was suffering from a chronic infection caused by Penicillium notatum. Surgical treatment and postoperative intravenous administration of amphotericin B resulted in complete recovery of the patient.
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PMID:[Penicillinosis of the paranasal sinuses]. 353 45

The Tolosa-Hunt syndrome is characterized by recurrent periods of painful ophthalmoplegia, dramatically ameliorated by steroid treatment. In half of the cases orbital phlebography shows characteristic changes. Ninety-six patients with orbital pain characteristic of the Tolosa-Hunt syndrome were submitted to orbital phlebography regardless of the existence of other symptoms. A pathologic phlebogram with changes typical of the Tolosa-Hunt syndrome was found in 50 patients. In 17 of these 50 patients the symptoms consisted of orbital pain only and no ophthalmoplegia. Twenty patients had pain and ipsilateral decrease of vision but no ophthalmoplegia, and 13 had painful ophthalmoplegia. Of 41 patients treated with steroid medication 39 responded dramatically with regard to the pain. Earlier findings indicate that the phlebographic changes are due to venous vasculitis, which thus may cause irreversible visual impairment but also chronic headache without ophthalmoplegia. It is concluded that the Tolosa-Hunt syndrome may be only one manifestation of a not uncommon disease.
Cephalalgia 1986 Mar
PMID:A new etiology for visual impairment and chronic headache. The Tolosa-Hunt syndrome may be only one manifestation of venous vasculitis. 369 95

Pituitary apoplexy with acute visual loss has to be considered as emergency operative indication. 3 cases presenting headache, rapid visual deterioration and ophthalmoplegia were operated upon from a transphenoidal approach. Immediate operative decompression proved to resolve the acutely evolved symptoms in all 3 cases.
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PMID:[Hypophyseal apoplexy, an urgent indication for surgery]. 376 62

Three cases of acute necrosis of a hypophyseal adenoma are reported with a review of the medical literature. The clinical presentation as an acute parasellar compression syndrome was the result of aseptic meningitis in 2 cases and of cavernous sinus thrombosis in the other; the usual symptoms of headaches, oculomotor paralysis and impairment of consciousness were observed. The diagnosis was suspected on clinical grounds, by the radiological changes of the pituitary fossa and confirmed by computerised axial tomography. All three patients had a favourable outcome. Surgery was only required in one case with threatening visual complications. Dissociated anterior pituitary deficiency persisted in all cases; two patients also had diabetes insipidus. In one case, the pituitary necrosis stabilised an acromegaly for a two year period.
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PMID:[Acute parasellar compression syndrome disclosing hypophyseal adenoma. 3 cases]. 383 9

A 60-year-old woman presented with a history of headache and rapidly progressive complete bilateral ophthalmoplegia. Her endocrine function was normal. Radiographic studies revealed signs of diffuse destruction of the sella turcica by a tumor without suprasellar extension. Biopsies of the lesion within the sphenoid sinus demonstrated the presence of a primary pituitary carcinoma; autopsy findings revealed metastatic deposits in the liver, kidney, and lung. The histological characteristics of these cells and the electron microscopic findings confirmed that the tumor can first manifest themselves by the rapid development of unilateral or bilateral ophthalmoplegia; this diagnosis should be considered in all individuals with such a syndrome.
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PMID:Primary pituitary carcinoma: a clinical pathological study. 397 20


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