| Identifier |
walsh_2022_s1_c3 |
| Title |
Some Heads Are Harder Than Others |
| Creator |
Steven Newman |
| Affiliation |
(SN) University of Virginia, Charlottesville, Virginia |
| Subject |
Orbit |
| History |
A 56 year old right handed patient was referred for an 'orbital problem.' Ten years earlier he had been told that nothing; could be done about the fact that his right eye position was not normal. In August 2015 vision was 20/50 OD and 20/300; OS, with the decreased vision on the left felt related to a cataract. Cataract surgery improvement vision OS. In April of 2016; visual acuity was 20/300 on the right and 20/25 on the left. Automated perimetry revealed severely constricted visual field; on the right with a small island of vision seen on a 10-2 with a V size test object. External examination revealed displacement of the right globe 30 mm inferiorly with a pupil to midline distance of 52mm OD and 30mm OS. Palpebral; fissures were 12 and 8 with an upper lid range of 8 and 14 with marked resistance to retropulsion on the right side. He had a 0.9 log unit right afferent pupillary defect with moderately severe limitation in elevation and abduction OD. OCT revealed nerve fiber layer thickness of 65 microns OD and 94 microns OS. He had essentially complete ganglion cell wipeout on the; right side, normal on the left. Review of his previous history was remarkable for being hit with a baseball bat in the forehead at age 4. At that time stitches were placed, but no imaging studies were done. He began to develop significant headaches in 1977, and was told that he had a fracture. He reportedly underwent surgery during which they 'scraped the; inside of the bone.' Post-operatively he had improvement in the headache. Over the last 10 years he feels that the eye has; progressively been displaced inferiorly and laterally. Imaging was reviewed. |
| Disease/Diagnosis |
Bing neel syndrome (BNS) as a first presentation of Waldenström's macroglobulinemia (WM) presenting like an atypical giant cell arteritis (GCA) |
| Treatment |
Post-traumatic reactive fibrous bone neoformation |
| Date |
2022-02 |
| References |
1. Harrison DF. Osseous and fibro-osseous conditions affecting the craniofacial bones. Ann Otol Rhinol Laryngol. 1984; 93:; 199-203; 2. Blanco M, Cabello-Inchausti B, Cura M, Fernandes L. Post-traumatic fibro-osseous lesion of the ribs and scapula; (sclerosing xanthofibroma) Ann Diagn Pathol. 2001; 5: 353-349; 3. McDermott MB, Kyriakos M, Flanagan FL. Posttraumatic fibro-osseous lesion of the rib. Hum Pathol. 1999; 30:770-780; 6. Kessler S, Mirra JM, Gordon |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
54th Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2022 |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2022. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6s4yran |
| Setname |
ehsl_novel_fbw |
| ID |
2100231 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6s4yran |
