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TitleCreatorHistory
226 Looking for a Drop of Porcelain - AbstractShannon J. Beres, Grant T. Liu, MD, Professor of Neurology, University of PennsylvaniaA 4 year old healthy boy presented with severe headache. A right subdural hygroma was seen on brain MRI and CSF evaluation showed a leukocytosis with elevated protein. A week later he developed left leg weakness and a repeat brain MRI showed progressive leptomeningeal enhancement and new punctate in...
227 Eyes and Bowels Bottled Up - Presentation PPTKristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. BrownA 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ...
228 Eyes and Bowels Bottled Up - AbstractKristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. BrownA 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ...
229 Eyes and Bowels Bottled Up - Path PPTKristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. BrownA 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ...
230 The Man with No Face (About Face)Michael S. Vaphiades, MD, University of AlabamaA 61-year-old man presented with one week history of decreased vision OS. Past medical historyincludes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes nomedications. He is retired but worked for 21 years in social science research. The remarkable thingupon meeting ...
231 Growing SuspicionAngela M. HerroA 44 year-old man presented to the emergency department in July 2011 for progressive painless visionloss in the right eye for 3 months. On presentation, vision was 4/200 in the right and 20/20 in the leftwith an afferent pupillary defect on the right. His visual field was full to confrontation but a...
232 Three Weeks in FloridaAndrew R. CareyA 36 year-old man presented with severe headaches, bilateral leg numbness, and bilateral decreasedvision. He was born in Ecuador where he received BCG vaccination and immigrated to US at age 19. In2005 he enrolled in nursing school and volunteered in homeless shelters. PPD was positive with anegativ...
233 Under PressureNathan H. KungA 29-year-old woman was referred to neuro-ophthalmology clinic for 1 year of headaches andpapilledema discovered 2 months earlier. She complained of recently blurred vision but no positionalheadache, pulsatile tinnitus, transient visual obscurations, or other neurologic issues. She used nomedication...
234 Hiding and Out of SightMichael L. MorganA 75-year-old white woman presented with a history of biopsy-proven giant cell arteritis (GCA)presented with recurrence of severe left sided headaches and left global ophthalmoparesis for 4 days.GCA had been diagnosed 4 months prior by biopsy. Left eye vision loss occurred when an outsidephysician t...
235 A Shot in the DarkJoshua PasolHistory & ExamA 74 year-old man with a chief complaint of difficulty with night time driving for several years as wellas difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism,GERD, glottic squamous cell cancer without recurrence, and a prior history of alc...
236 Requim for a Cabinet MakerJennifer I. DoyleA 54-year-old white male presents with 3 weeks of painless horizontal nystagmus and 6 months of leftsided forehead numbness. He reports a 20 lbs weight loss. Medical history includes a renal transplant 30years prior. He takes prednisone 30 mg QOD and azathioprine. Visual acuity is 20/20 OU, color vi...
237 Shady Double CrosserFrancine WeinA 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and atwo week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors.Her past medical history was significant for a cholecystectomy and Crohns disease, for which she ha...
238 Using MuscleNagham Al-ZubidiA 30- year-old Saudi female student with no past medical history presented an eight month history ofprogressive blurred vision primarily at near, anisocoria OS, and periocular discomfort with eyemovements. Neuro-Ophthalmologic examination revealed best corrected visual acuity of OD 20/20 andOS 20/30...
239 Who Deserves a Second Chance?Lina NagiaAn 81-year-old woman presents with a one-month history of blurred vision OS, acutely worse in thepast 5 days. She reports pain with left gaze, left sided forehead tenderness and some weightloss. Medical history includes hypertension, borderline diabetes, cerebral vascular accident and basalcell carc...
240 A Weak PresentationReuben M. ValenzuelaAn 82-year-old right-handed man with myasthenia gravis presented in May 2014 with double vision andright facial numbness and weakness. He was first seen in 1998 with horizontal diplopia. He had anabduction deficit of the right eye, and right nasolabial fold flattening. He was diagnosed withmyastheni...
241 Star Spangled BanneDara M. BierA 12-year-old girl with a history of bilateral optic nerve enlargement, enterovirus meningitis, seizures,and bilateral hygromas, presented with acute onset chronic vision loss in her left eye. Two years prior,she presented to an outside hospital with headaches, intermittent speech arrest and right-s...
242 Nobody's PerfectAlexander KsendzovskyIn June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1she haddeveloped headaches and was found to have a posterior fossa tumor. In El Salvador she was treatedwith shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwenta shunt revis...
243 I Can't See StraightSteven A. NewmanIn May of 2014 this 30 year old right handed patient was referred for consultation regarding diplopiaand dizziness. The patient relates that she had been told that she had tired eyes as a child. Two and ahalf years ago she began to have intermittent exodeviation. She was seen locally and diagnosed a...
244 Lights OutJohn J. BrinkleyA 78 year-old man presented with a one-month history of progressive painless binocular vision loss. Hehad sustained head trauma without loss of consciousness three days prior to the onset of vision loss. Onthe morning of his presentation to us, he had awoken with complete binocular vision loss and h...
245 It's Not Just a FAD, (EHR Fatigue Syndrome)Jacqueline A. LeavittA 29 year-old female nurse, nine months postpartum, presented with an inability to see her computerwell for the past two months. She denied eye pain, diplopia, numbness, tingling or weakness. Therewere no changes in vision in bright vs. dim lighting. She also had a headache at the back of her head f...
246 Now you see it. Now you don't.Prem S. SubramanianA 70 yo RH African American female presented to our institution with sequential, severe vision loss inthe preceding 4 months. Her past medical history included well-controlled hypertension andhyperlipidemia, CAD s/p coronary stent placement x 2 after MI, and stroke. She had no prior history ofvisual...
247 Some Like it HotAhmara G. RossHistory & ExamA 71 year old Caucasian man with a past medical history of hypertension, hyperlipidemia, Type 2 DM,ESRD status post renal transplant, facial melanoma, currently on ASA for a stable left sided putaminalhemorrhage presented with new right sided ptosis and lower extremity weakness. Brain ...
248 SpeakeasyJoseph G. ChackoA 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touchedthe inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had startedone month ago. He also complained of foreign body sensation and discomfort in the right eye f...
249 Joe & Jerry Flew the CoopLulu L. C. D. BursztynA previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed oneday later by lethargy and vision loss. Past medical history was significant only for acne, for which shehad been treated with doxycycline 40 mg/day intermittently starting 2 months prior to sympto...
250 Bariatric Surgery and the Neuro-OphthalmologistHeather E. Moss
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