| Identifier |
walsh_2015_s4_c4-1 |
| Title |
I Can't See Straight |
| Creator |
Steven A. Newman; T. Ben Ableman |
| Affiliation |
University of Virginia Charlottesville, VA |
| Subject |
MRI imaging, Cystic Intracranial Lesions, Virchow-Robin Spaces |
| History |
In May of 2014 this 30 year old right handed patient was referred for consultation regarding diplopia and dizziness. The patient relates that she had been told that she had 'tired eyes' as a child. Two and a half years ago she began to have intermittent exodeviation. She was seen locally and diagnosed as having a IV nerve palsy and treated with 2 diopters of base in prism and 2 diopters of base up prism. Six months before her referral she began to complain of double vision. The patient attributed the onset of double vision to a car accident in 2007. On examination visual acuity was correctable to 20/20 and 20/25. Color was intact. Visual fields demonstrated an inferior Seidel scotoma on the right side. There was no afferent pupillary defect. Motility examination revealed severe limitation in up gaze OD > OS with 45 diopters of right exotropia and 12 diopters of right hypotropia. Counter clockwise torsional nystagmus was noted. Slit lamp examination and applanation tensions were within normal limits. Funduscopic examination revealed no evidence of disc edema or optic atrophy. OCT revealed some epiretinal surface changes, but no obvious epiretinal membrane. Imaging studies were obtained. |
| Disease/Diagnosis |
Giant tumefactive mesencephalic spaces of Virchow-Robin. MRI scan demonstrated "multiple large clusters of expanded fluid filled perivascular spaces with CSF characteristics involving the entire central left midbrain and left thalamus involving the left optic tract, hypothalamus, interpeducular cistern, left ambient cistern, collicular plates, and pons." |
| Date |
2015-02 |
| References |
1. House P, Slazman KL, Osborn AG, MacDonald JD, et al. Surgical considerations regarding giant dilations of the perivascular spaces. J Neurosurg 2004; 100:820-824; 2. Patankar TF, Mitra D, Varma A, Snowden J et al. Dilation of the Virchow-Robin spaces: MR appearance. Am J Neuroradiol 2005; 16: 1238-1242; 3. Rohls J, Riegel T, Khalil M, Iwinska-Zelder J, et al. Enlarged perivascular spaces mimicking multicystic brain tumours. Report of two cases and review of the literature. J Neursurg 2005; 102 (6): 1142-1146 4. Salzman KL, Osborn AG, House P, Jinkins R, et al. Giant Tumefactive Perivascular Space. Am J Neuroradiol 2005; 26: 298-305 5. Stephens T, Parmar H, Cornblath W. Giant tumefactive perivascular spaces. J Neurol Sci 2008; 266: 171-3 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Source |
47th Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| 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 2015. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6ff6q00 |
| Setname |
ehsl_novel_fbw |
| ID |
179287 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6ff6q00 |
