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51 Junctional Scotoma from a Sellar MassThis is a case of a 55-year-old woman presenting with gradual painless vision loss in both eyes. Although visual acuity was 20/20 in both eyes, there was a left relative afferent pupillary defect and diffuse pallor of both optic nerves (Figure 1). Visual fields (24-2 SITA-Fast) showed a temporal def...Jonathan A. Micieli, MD; Valérie Biousse, MD
52 Central Retinal Artery Occlusion with Cilioretinal Artery SparingCentral retinal artery occlusion with sparing of the cilioretinal artery Figure 1 : Fundus photographs show retinal whitening in the right eye, with sparing of the perfused retina in the distribution of the cilioretinal artery (arrows); the left eye has a normal funduscopic appearance. Figure 2 : Mo...Supharat Jariyakosol, MD; Valérie Biousse, MD
53 Cerebral Venous Sinus Thrombosis with PapilledemaA case of superior sagittal sinus, right transverse sinus and right sigmoid sinus thrombosis, presenting with increased intracranial pressure (headaches, bilateral sixth palsy and papilledema). Figure 1 : Disc photos of the right and left eyes demonstrating bilateral disc edema. Figure 2 : Non-contr...Supharat Jariyakosol, MD; Valérie Biousse, MD
54 Posterior Cerebral Artery Infarction from Vertebral Artery DissectionRight posterior cerebral artery ischemic infarction due to post traumatic (martial arts) left vertebral artery dissection with resulting right PCA occlusion. Left homonymous hemianopia due to right occipital lobe infarction and left hemisensory loss due to right thalamic infarction. Imaging of the a...Kristen Hudson, MD; Valérie Biousse, MD
55 Giant Cell Arteritis: Temporal Artery Anatomy and HistologyGross anatomy and histology of the normal superficial temporal artery.; Histopathology of the superficial temporal artery involved by active and healed GCA; Summary of the main histopathologic findings in GCASamuel Bidot, MD; Valérie Biousse, MD
56 Cerebral Arterial VascularizationArteries of the neck and brain as seen on a CT Angiogram. Figure 1 : Overview. Figure 1A. Anterior view. Figure 1B. Lateral view. Figure 2 : Internal carotid artery. Segmentation. Figure 3 : Internal carotid artery and vertebral arteries. Extracranial part. Posterolateral view. Figure 4 : Internal c...Samuel Bidot, MD; Valérie Biousse, MD
57 Cerebral Venous VascularizationMRV and CTV scan imaging of the brain veins. Figure 1 : Overview. MRV with contrast Figure 1A. Right postero-lateral view. Figure 1B. Sagittal view. Figure 2 : Dural sinuses. Superior endocranial view. CTV. Figure 3 : Dural sinuses. Sagittal endocranial view. CTV. Figure 4 : Dural sinuses. Right an...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
58 Osseous Anatomy of the Optic CanalsAnatomic study of the optic canals using 3D reconstruction of CT scan images. Figure 1 : Orbital canal seen through the orbit Figure 2 : Optic canal seen from the intracranial side (1) Figure 3 : Optic canal seen from the intracranial side (2) Figure 4 : Optic canal : axial plane Figure 5 : Optic c...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
59 Anatomy of the Trigeminal NerveMRI and CT scan imaging of the trigeminal nerve and its 3 divisions. Figure 1 : trigeminal nerve. Overview Figure 2 : trigeminal nuclei Figure 3 : trigeminal root. Cisternal segment. Figure 3A. FIESTA axial image through midpons. Figure 3B. T2 coronal image through prepontine cistern Figure 4 : trig...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
60 Radiologic Appearance of Unilateral Sphenoid Wing Hypoplasia in Neurofibromatosis Type IMRI features of greater wing sphenoid hypoplasia in the setting of neurofibromatosis type 1. - Figure 1 : Orbital MRI with contrast showing right greater sphenoid wing hypoplasia. The lack of bone tissue leads to herniation of the right temporal lobe into the orbit, pushing forward the orbital conte...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
61 Pulsatile Proptosis from Sphenoid Wing Hypoplasia in Neurofibromatosis Type 1Clinical and radiologic features of greater wing sphenoid hypoplasia in the setting of neurofibromatosis type 1. Figure 1 : slit lamp examination showing Lisch nodules; Figure 2 : orbit CT scan (1); Figure 3 : orbit CT scan (2) with annotations. For visual examples of this disorder, please see the...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
62 Direct Carotid-Cavernous Sinus FistulaA 40-year-old man presented with decreased vision and redness in his left eye. He had a significant trauma to the left side of his face about one year ago, but did not seek medical attention. External examination showed significant proptosis of the left eye (Figure 1) and conjunctival injection and ...Jonathan A. Micieli, MD; Valérie Biousse, MD
63 Sturge-Weber SyndromeA case of Sturge-Weber syndrome (Encephalotrigeminal angiomatosis) with angiomas that involve the leptomeninges, and the skin of the ipsilateral hemiface, associated with congenital glaucoma in the same eye. Various illustrations are included to demonstrate the port wine stain, enlarged optic nerve ...Supharat Jariyakosol, MD; Valérie Biousse, MD
64 Ocular Hypoperfusion from Severe Internal Carotid Artery Stenosis68 year-old man complaining of mildly decreased vision OD with fluctuation of vision throughout the day. Fluorescein angiography shows delayed choroidal and retinal fillings, suggesting hypoperfusion of the right eye.Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
65 Occipital Infarction with Incomplete Congruent Homonymous HemianopiaCT appearance of a remote occipital infarction. Congruent homonymous hemianopia.Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
66 Terson Syndrome and Subarachnoid HemorrhageA case of Terson syndrome resulting with subarachnoid hemorrhage and right vitreous hemorrhage resulting from a left pericallosal artery aneurysm. Figure 1 : External photograph of right eye demonstrates blunted red reflex secondary to vitreous hemorrhage Figure 2 : External photograph of left eye d...Joshua Levinson, MD; Valérie Biousse, MD
67 Terson Syndrome With Cranial Nerve 3 Palsy Due to Subarachnoid Hemorrhage from Arteriovenous Malformation and Aneurysmal RuptureA case of Terson syndrome due to AVM and posteral cerebral aneurysm. The patient developed a left CN3 palsy due to hematoma involving the left midbrain. Figure 1 : External photograph of right eye demonstrates blunted red reflex secondary to vitreous hemorrhage Figure 2 : External photograph of lef...Joshua Levinson, MD; Valérie Biousse, MD
68 Internal Carotid Artery / Posterior Communicating Artery Aneurysm with Third Nerve Palsy Shown on CT AngiogramInternal Carotid Artery / Posterior Communicating Artery Aneurysm with Third Nerve Palsy Shown on CT Angiogram ; anatomic description of vascular and bony findings on the CTA. - Figure 1 : 51 year-old man complaining of painful binocular diplopia. Orange arrows indicate the direction of gaze. In p...Samuel Bidot, MD; Amit M. Saindane, MD; Valérie Biousse, MD
69 Sellar Aneurysm with Chiasmal CompressionThis is a case of aneurysm of the internal carotid artery, invading the sella and complicated by chiasmal compression and bitemporal hemianopia. Figure 1 : Humphrey visual fields (gray scale and pattern deviations) Figure 2a : T1-weighted axial brain MRI (1): well defined circular intracerebral mass...Rabih Hage, MD; Valérie Biousse, MD
70 Large Right Hypophyseal Aneurysm Causing a Junctional ScotomaRight, multi-lobulated superior hypophyseal artery aneurysm measuring 1.6 x 1.2 x 2.2 cm with 6 mm neck causing a right junctional scotoma . Images from a brain CT with contrast, a brain CT angiography with contrast, cerebral angiogram, Humphrey visual fields and ocular fundus photographs are includ...Laurel N. Vuong, MD; Valérie Biousse, MD
71 Previous Branch Retinal Artery OcclusionThis is a typical case of an old branch retinal artery occlusion in a 64 year old woman presenting with persistent monocular vision loss. She had sudden onset of painless vision loss in the inferior field of her left eye approximately one year prior. Her past medical history was significant for atri...Benson S. Chen, MBChB FRACP; Valérie Biousse, MD
72 Choroidal Infarction in Giant Cell ArteritisAn 80-year-old Caucasian woman presented with a 10-day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. Examination showed characteristic large area of choroidal ischemia that is well-known to be associated wit...Wael A. Alsakran, MD; Andre Aung, MD; Valérie Biousse, MD
73 Cotton Wool Spots in Giant Cell ArteritisThis is a case of cotton wool spots in a patient with temporal artery-biopsy proven temporal arteritis.; ; A 66-year-old woman presents with isolated painless vision loss related to a left optic neuropathy in her left eye. She denies systemic symptoms to suggest giant cell arteritis.; Her examinatio...Rahul A. Sharma, MD, MPH; Valérie Biousse, MD
74 Classic Pathology Findings in Giant Cell ArteritisAn 80-year-old Caucasian woman presented with a 10 day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. Pathology findings were classic for giant cell arteritis with numerous inflammatory cells in the tunica me...Andre Aung, MD; Corrina Azarcon, MD; Wael A. Alsakran, MD; Valérie Biousse, MD
75 MRI Findings in Giant Cell ArteritisCase 1. An 80-year-old Caucasian woman presented with a 10-day history of headaches, intermittent binocular diplopia, and jaw pain. Temporal artery biopsy confirmed a diagnosis of giant cell arteritis. MRI with contrast showed enhancement of bilateral optic nerve sheaths in addition to enhancement o...Wael A. Alsakran, MD; Andre Aung, MD; Valérie Biousse, MD
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