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1 Aberrant Regeneration Third NerveGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine48 year old woman S/P rupture and repair of right sided posterior communicating artery aneurysm Video shows residual partial right third nerve palsy, with aberrant regeneration, causing a pseudo Von Graefe's sign (elevation of the right upper eyelid with attempted infraduction of the right eye)
2 Pseudotumor cerebriDeborah I. Friedman, M.D., Departments of Ophthalmology and Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New YorkThis one hour presentation on Pseudotumor cerebri is the first in a series of Neuro-Ophthalmology All Star Grand Rounds. The videolecture is accompanied by written material and is intended as a teaching tool for medical residents. Studies in the 1980s calculated the annual incidence of pseudotumor c...
3 2013 William F Hoyt Lecture: Neuro-Ophthalmology in Review: Around the Brain with 50 FellowsNancy J. Newman, MD, LeoDelle Jolley Chair of Ophthalmology, Director, Section of Neuro-Ophthalmology, Professor of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta, GeorgiaNo matter what their ultimate specialty, every ophthalmologist needs to master the basics of neuroophthalmology. To that end, we must ensure that we continue to train effective teachers of neuro-ophthalmology. This is William F. Hoyt's most important lasting legacy and charge. In this same spirit, E...
4 Superonasal Transconjunctival Optic Nerve Sheath Decompression (stONSD)Kevin E. Lai, MD, Dean McGee Eye Institute, Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, Neuro-Ophthalmology Institute, Indianapolis, IN; Kenneth C. Lao, MD, Dean McGee Eye Institute, Department of Ophthalmology, University of Oklahoma Health Science...This video demonstrates the surgical technique and outcomes of a modified medial transconjunctival approach to optic nerve sheath decompression (ONSD).
5 Bilateral acquired Brown's syndromeRyan D. Walsh, MDDepartment of Ophthalmology and Visual Sciences, The Eye Institute, Medical College of Wisconsin; Department of Neurology, Medical College of Wisconsin; Collin McClelland, MDDepartments of Ophthalmology and Visual Neurosciences. University of Minnesota, Minneapolis, Minnesota.A 27 year old female with a history of Sjogren's syndrome reported a 2 year history of a vertical binocular diplopia with looking up-and-to-the right. She has also noticed an audible "click" when positioning her eyes in this direction. As depicted in the video, when attempting to look up-and-to-the...
6 Apraxia of Eyelid OpeningRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitPatient has Parkinson disease and has developed this condition following deep brain stimulation.
7 Cogan's Lid Twitch SignRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitCogan's lid twitch sign is a twitch sign of he upper lid upon looking straight from a sustained downgaze position. It is associated with Ocular Myasthenia Gavis.
8 Congenital Oculomotor ApraxiaRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitCongenital Ocular Motor Apraxia is an uncommon condition that causes children to have difficulty moving their eyes horizontally or from side to side. They are usually unable to quickly move their eyes from side to side and often have to turn their head (head jerking) and not just their eyes to track...
9 Parinaud SyndromeRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitParinaud syndrome, as called dorsal midbrain syndrome, is due to dorsal midbrain lesions from compression (e.g., a tumor), demyelination, or ischemia. The syndrome is characterized by limitation of upward gaze, convergence retraction nystagmus, light near dissociation, and lid retraction (Collier's ...
10 Downbeat Nystagmus Anti-GAD Cerebellar SyndromeRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitA patient with Anti-GAD positive Cerebellar syndrome with ataxia and opsoclonus due to downbeat nystagmus , treated with Baclofen with some improvement.
11 Marcus Gun Jaw WinkingRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitMarcus Gunn Jaw Wink causes congenital ptosis and eyelid retraction associated with jaw movement or sucking. It's due to "miswiring" between 3rd and 5th cranial nerves. The treatment of ptosis in children is surgery to prevent amblyopia .
12 Ocular NeuromyotoniaRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitOcular Neuromytonia is a characterised by by paroxysmal tonic contraction of the extraocular muscles supplied by the oculomotor nerve. It is has been reported after cranial radiation therapy, especially to the sellar-parasellar region and from compressive lesions such tumours or aneurysms. The patho...
13 Oculopalatal TremorRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitThis is a usually vertical, pendular nystagmus associated with synchronous rhythmic movement of the palate, developing months after a severe brain stem stroke. The stroke involves the dentato-rubro-olivary tract (Mollaret's triangle). MRI can show hypertrophy of the inferior olivary nucleus in the m...
14 Optic Nerve Sheath FenestrationRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitOptic nerve sheath fenestration is performed to manage papilledema causing progressive loss of vision , due to raised intracranial pressure from Idiopathic Intracranial Hypertension or Cerebral Venous Sinus Thrombosis. The procedure is usually performed in cases of severe visual field loss or when m...
15 Periodic Alternating NystagmusRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitPAN is a nystagamus characterized by a cycle of uniderectional jerk nystagamus for 60-90 sec , a pause for 10-20 sec and a a cycle of a jerk nystagmus in the opposite direction for 60-90 sec. It is found in brain stem and cerebellar conditions as well as ocular albinism ( as in this patient).
16 Pulsating ExophthalmosRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitThis patient had brain surgery with bone removal resulted in transmission of CSF pulsation into the orbit and pulsating exophthalmos. This sign can also be seen in patient with neurofibromatosis with hypoplasia of the sphenoid wing bone.
17 Square Wave Jerks with ContrapulsionRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitA patient with history of brain stem stroke 2 months ago (right hemifacial anesthesia , left sided weakness and bulbar symptoms dysphagia) comes complaining of oscillipsia , binocular vertical diplopia). On exam he had a vertical tropia of 3-4 PD (Skew deviation), dissociated nystagmus , and saccadi...
18 See-Saw NystagmusRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitSee-saw nystagmus is a localizing nystagmus to lesions of the sellar and parasellar region. "It's characterized by synchronous elevation and intorsion of one eye and depression and extorsion of the contra lateral eye . This patent has a craniopharyngioma, which was operated twice, optic atrophy and ...
19 See-Saw NystagmusRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitThis nystagmus localizes to lesions supra/parasellar region (Large sellar and hypothalamic lesion) and is characterized by a see saw movement of elevation/intorsion of one eye and depression/extorsion of the other eye in a pendular fashion. This patient had a large pituitary macro-adenoma with supra...
20 Temporal Artery BiopsyRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitThis is a video of Superficial Temporal Artery Biopsy done under local anaesthesia for a patient who was suspected to have Giant Cell Arteritis (GCA. GCA is vasculitis of the medium sized vessels than can lead to permanent visual loss by causing Arteritis Ischemic Optic Neuropathy. The diagnosis of ...
21 Upbeat NystagmusRaed Behbehani, MD, Al-Bahar Ophthalmology Center, Kuwait City, KuwaitA patient with a brain stem syndrome due to demyelination and upbeat nystagmus.
22 The Spinal Cord & Monosynaptic Reflex: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe spinal cord's relationship to the foramina, discs and spinal nerves is demonstrated on a model. The dura, ganglia and rootlets are shown as well as the gray and white matter in gross sections at different levels. A model of the cord is used to demonstrate and describe the anatomy of a monosynapt...
23 The Unfixed Spinal Cord: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe spinal cord's relationship to the foramina, discs and spinal nerves is demonstrated on a model. The dura, ganglia and rootlets are shown as well as the gray and white matter in gross sections at different levels. A model of the cord is used to demonstrate and describe the anatomy of a monosynapt...
24 Three Critical Vertical Pathways: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThere is one motor and two sensory pathways that must be mastered. Pain and temperature from the body travel together and vibration and proprioception travel in another pathway each reaching perception in the cortex. Voluntary motor control starts in the cerebral cortex and connects with a motor neu...
25 Sensation from the Body: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahSensation consists of various modalities, which tend to travel in one of two pathways. The Anterolateral System also known as the Spinothalamic Tract carries pain and temperature. The Dorsal Column-Medical Lemniscus Pathway carries vibration, joint position, and fine 2-point discrimination. Light or...
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