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26 Orientation: The Planes of the Brain: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahTerms such as anterior, posterior, inferior and superior are introduced with respect to the hemispheres as well as the brain stem. Terms such as rostral and caudal or dorsal and ventral can mean different things in different areas. Sections in three planes (frontal, axial, and sagittal) are demonstr...
27 The Meninges: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe epidural, subdural and subarachnoid spaces are demonstrated and discussed with respect to trauma and disease. The relationship of the brainstem and cerebellum to the tentorium demonstrates the vulnerability of the brain stem to increased supratentorial pressure and herniation. Arachnoid granulat...
28 The Ventricles: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe ventricles are demonstrated and named on a model cast as well as in rotating 3D reconstructions. The production, function, circulation and removal of CSF produced by the choroid plexus is discussed using a diagram and then reviewed on frontal, axial and sagittal brain specimens and corresponding...
29 Cranial Nerves: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe approach is to learn to associate the cranial nerves with their brainstem level and blood supply. Emphasis is given to the midbrain (3, 4), pons (5, 6, 7, 8), medulla (9, 10, 11, 12) and their most important functions.
30 Brain Stem & Reflexes: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe cranial nerves are reviewed again on a specimen with vessels. Next, landmarks on gross brain stem sections are shown. Stressed are the three reflexes associated with each of the three levels: pupillary, corneal and gag reflexes and their associated cranial nerves. Finally cross sections of myeli...
31 Cerebral Circulation: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe major vessels of the anterior and posterior circulation are demonstrated along with the Circle of Willis on both a model and in an animation. The distribution of the three major cerebral arteries is demonstrated along with the concept of a watershed zone. A gross specimen with good vessels is al...
32 Cortical Localization: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThe lobes of the brain are defined together with their major functions. The visual field representation in the occipital lobe is explained with a diagram. Speech areas and the major types of aphasia are discussed in the dominant hemisphere and parietal lesions of neglect and spatial orientation are ...
33 Sensation from the Face: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahSensation from the face travels in one of two pathways both of which eventually converge to form the trigeminothalamic tract that reaches the thalamus. The tract that carries pain and temperature is confusing because it first descends before crossing while the equivalent of Dorsal Column-Medical Lem...
34 Control of the Pupil: Neuroanatomy Video Lab - Brain DissectionsSuzanne S. Stensaas, PhD, Professor Emeritus, Department of Neurobiology and Anatomy School of Medicine, University of UtahThrough diagrams, animations and gross specimens the constriction and dilation of the pupil by the autonomic nervous system are described. Both the parasympathetic and sympathetic control are traced and the importance of a constricted pupil, Horner's Syndrome, and temporal lobe (uncal) herniation (d...
35 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...
36 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.
37 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.
38 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...
39 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 ...
40 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.
41 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 .
42 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...
43 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...
44 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...
45 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).
46 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.
47 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...
48 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 ...
49 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...
50 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 ...
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