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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The symptomatology in six cases with spontaneous carotid-cavernous fistulas is discussed. All six patients presented with exophthalmos, dilated veins, pain and restriction of ocular movements. In four patients a bruit was found objectively as well as subjectively, four patients exhibited an increase of the intraocular pressure and in three cases vision was impaired. Of special interest is the finding that discrete symptoms such as venous congestion and slight pain appeared early in the course of the disease in all patients, and that in some of the patients an increase in intraocular pressure as well as disturbances in ocular motility were diagnosed long before the appearance of the exophthalmos.
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PMID:Spontaneous carotid-cavernous fistulas. Clinical symptomatology. 13 66

The potential for using CT to diagnose orbital lesions is clearly demonstrated in this chapter. The patients discussed were all suffering from proptosis and had other complaints such as visual disturbances, pain, or ophthalmoplegia. CT is superior to ultrasonography in its ability to reproduce anatomical structures, including the retroocular space, bony walls of the orbit, and extraorbital regions, such as ethmoid sinuses and the cranial cavity. Such reproduction helps distinguish lesions arising within the orbit from those invading the orbit from outside. CT not only defines the extent of a lesion but also provides information about the physical properties of the tissue. The remarkable difference on CT between proptosis caused by thyrotoxic disease and that caused by intraorbital tumor or pseudotumor is a striking example of the way in which CT may contribute to more accurate diagnosis.
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PMID:Computerized tomography of the orbit. 34 4

An 18-year-old woman had a rapidly progressive proptosis, vascular congestion, and orbital pain. Ultrasonographic and radiologic tests supported the diagnosis of a solid vascularized mass that proved histologically to be an alveolar soft-part sarcoma of the orbit. Uncertainty as to the histogenesis of alveolar soft-part sarcoma still exists, but prognosis for patient survival is poor.
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PMID:The ultrasonographic and radiologic features of a histologically proven case of alveolar soft-part sarcoma of the orbit. 45 7

Seventeen patients had spontaneous orbital hemorrhages. The usual symptoms were acute onset of pain, proptosis, and vomiting with decreased vision, limitation of motility, and ecchymosis of the eyelids occurring in some patients. The children often developed a progressive space occupying lesion that simulated a neoplasm. Most patients had underlying venous anomalies, although several elderly patients with atherosclerosis developed arterial hemorrhages with more abrupt and dramatic symptoms. Other associated conditions included hypertension, anemia, labor, and von Willebrand's disease. The visual outcome was good except in the elderly patients, half of whom had severe and permanent visual loss.
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PMID:Orbital hemorrhage. 47 97

Three cases of histologically verified neurinomas of the oculomotor nerve are reported. The preoperative diagnosis in all three cases was not made; on the contrary all cases were diagnosed as sphenoid ridge meningiomas. The oculomotor neurinoma manifests itself in the beginning with a discrete progressive palsy of the oculomotor nerve leading in later stages to complete ophthalmoplegia. Proceeding the oculomotor nerve paresis or going parallel to it is a functional loss of the homolateral optic nerve sometimes progressing to amaurosis. Unilateral exophthalmos as well as frontal or orbital neuralgic pain with or without sensory disorders in the area of trigeminus-I are characteristic for the clinical picture in later stages, all symptoms characteristic for the syndrome of the apex orbitae, resp. the superior orbital fissure, resp. the anterior cavernous sinus. The differential diagnosis has to consider above all the sphenoid ridge meningioma, the trigeminal neurinoma and the numerous tumors within the cavernous sinus (aneurysmas, meningiomas, chondromas, metastases of carcinomas, pituitary adenomas etc.) or the middle cranial fossa. Plain X-ray, carotid angiogram and computer tomogram are essential diagnostic means for localization and extension of the tumor but not for histological diagnosis. Oculomotor neurinomas are very seldom. The three observed cases did not have any relation to a possible generalized neurofibromatosis.
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PMID:[Neurinoma of the oculomotor nerve (author's transl)]. 65 Dec 44

We studied four patients with posterior brawny scleritis. Two underwent enucleation for suspected melanoma, and in the other two, the correct diagnosis was made and effective therapy begun. Of seven other eyes with brawny scleritis from other sources, five were enucleated after diagnosis of choroidal melanoma and one for suspected intraocular tumor. This experience and other previous reports indicate the high incidence of diagnostic confusion regarding brawny scleritis. We therefore emphasized clinical symptoms and signs of brawny scleritis: inflammation, tenderness or pain of the globe, history of collagen vascular disease, proptosis, bilaterality, and retinal and choroidal detachment. A preserved normal choroidal vascular pattern over an elevated subretinal mass may be indicative of posterior brawny scleritis. Scleral biopsy is useful for tissue diagnosis. Radioactive phosphorus uptake tests and ultrasonography may erroneously indicate choroidal melanoma and lead to enucleation of a potentially salvageable globe.
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PMID:Clinical manifestations of brawny scleritis. 67 4

The cases of 29 patients aged 20 years or less with orbital inflammatory pseudotumor were studied retrospectively. There was no sex predilection, although the left orbit was involved twice as often as the right. Patients typically had abrupt onset of periocular pain, early-morning swelling, chemosis, conjunctival and extraocular muscle injection, proptosis, a palpable mass, and extraocular motility disturbances. Visual acuity was usually only mildly affected at onset. Forty-five percent of patients had or subsequently developed bilateral orbital involvement in the absence of notable systemic diseases. Papilledema and iritis were seen in 35% of patients, respectively, particularly in bilateral cases. All cases responded to steroids, but bilateral disease was the most apt to become steroid dependent. Permanent functional impairments were seen most commonly in patients who had alternating recurrent bilateral disease or who underwent surgical exploration.
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PMID:Idiopathic inflammatory orbital pseudotumor in childhood. I. Clinical characteristics. 67 81

A 53-year-old woman had a six-month history of proptosis, pain, and decreased vision in the right eye. Skull X-ray films and polytomography demonstrated a giant, mushroom-shaped osteoma originating from the roof of the maxillary sinus and invading the orbit. The tumor was removed by a lateral orbital approach with prompt resolution of proptosis and pain, and recovery of normal vision and ocular motility. This patient is one of 34 patients with 38 paranasal sinus osteomas examined here in the last 25 years. Only six patients have had orbital symptoms or signs.
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PMID:Giant, mushroom-shaped osteoma of the orbit originating from the maxillary sinus. 86 59

A carotid-cavernous fistula in pregnancy is not rare. Increasing pain and worsening of the proptosis made prompt operative intervention necessary. The fact that other known cerebrovascular lesions lend themselves to surgical attack without undue risk during this time8--11 prompted us to proceed with surgery. There was no adverse effect on the pregnancy, other than premature delivery. Both the mother and child are doing well 4 years after surgery.
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PMID:Carotid cavernous fistula in pregnancy. 90 15

A 47-year-old uncontrolled diabetic presented with proptosis, pain, immobility of the globe, and a perforated corneal ulcer. The clinical impression of mucormycosis was erroneous. Hemophilus aegyptius was grown from the orbit, the vitreous and oropharynx. This is believed to be the first report of panophthalmitis due to this organism.
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PMID:Hemophilus orbital cellulitis and panophthalmitis simulating mucormycosis. 91 Nov 15


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