A Night at the Met - Presentation PPT

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Identifier walsh_2016_s2_c4-1
Title A Night at the Met - Presentation PPT
Creator Clotilde Hainline, Janet C. Rucker, David Zagzag, Yvonne W. Liu, Floyd A. Warren, Laura J. Balcer, MD, Professor, Department of Neurology, NYU Langone; Steven L. Galetta, MD, NYU Langone
Subject Vision Loss; Visual Field; Prosopagnosia; Cerebral Amyloid Angiopathy; Amyloid-Beta Related Angiitis; Intracerebral Hemorrhage Intracerebral Hemorrhage
History A 73-year old woman with no headache history presented to the emergency department with several days of right-sided, retro-ocular, and vertex headaches and inability to see the left side of the TV screen-- all beginning 1 week after cataract surgery. Evaluation by her ophthalmologist was unrevealing. Eight years earlier, she had been diagnosed with stage 1a lung adenocarcinoma and had undergone wedge resection. One year later, she developed hematuria and left arm edema. A bladder scan showed increased uptake, and she was diagnosed with metastatic stage 3 bladder cancer. She was considered in remission from both malignancies. On our examination, she was normotensive. Visual acuities were 20/20 OD and 20/25 OS. Color vision was normal. Pupils were symmetric and brisk without APD. She had a left homonymous hemianopia to confrontation. The remainder of the examination was normal. Brain CT showed a 2 cm right occipitotemporal hemorrhage with surrounding edema. Brain MRI was consistent with an acute hematoma, showing subtle patchy rim enhancement and a suggestion of smooth thin dural or leptomeningeal enhancement over the right hemisphere. Gradient echo MRI showed no microhemorrhages. CT angiogram (to look for an underlying AVM), and CT of the chest/abdomen/pelvis (to look for primary malignancy) were negative. Three weeks later, she developed prosopagnosia. Brain MRI showed several new lesions adjacent to the original hemorrhage. There were new hemorrhages in the original lesion and more prominent peripheral enhancement. Echocardiogram to exclude marantic endocarditis was unremarkable. Digital cerebral angiography was normal. A procedure was performed.
Date 2016-02-28
Language eng
Format application/pdf
Type Text
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2016
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
ARK ark:/87278/s69c9v19
Contributor Primary Clotilde Hainline, Janet C. Rucker, David Zagzag, Yvonne W. Liu, Floyd A. Warren, Laura J. Balcer, Steven L. Galetta
Setname ehsl_novel_fbw
ID 179350
Reference URL https://collections.lib.utah.edu/ark:/87278/s69c9v19
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