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176 Neuro-Ophthalmic Vascular DiseaseMark J. Kupersmith, MDA 9-year-old boy had recurrent ischemic episodes that had begun 2 years prior to evaluation. A significant right hemiparesis and a significant speech, learning, and memory disorder were present. His noncontrast axial view CT scan demonstrated multiple cerebral infarcts. Cerebral angiography revealed...
177 Neuro-Ophthalmic Vascular DiseaseMark J. Kupersmith, MDMR angiography was performed on this 33-year-old woman, who complained of the onset of a bad taste in her mouth followed by pain along the left forehead and development of the left third-order Horner's syndrome during pregnancy. Except for the Horner's syndrome, the patient was neurologically intact...
178 Neuro-Ophthalmic Vascular DiseaseJacqueline A. Leavitt, MDArteriovenous malformations are dysplastic vascular channels. They may result in neuro-ophthalmologic findings from direct compressive effects, secondary hemorrhage, or secondary seizure disorder. CT and/or MRI may demonstrate the lesion, but cerebral arteriography is usually required to better defi...
179 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 23-year-old woman has had insulin-dependent diabetes mellitus since age 3. She was diagnosed with Sydenham's chorea in early childhood and had grand mal seizures from age 13 to 15. She has been hypertensive since age 18. Her vision was 20/25 OD and 20/40 OS, with dyschromatopsia OS, and a 1.8 l...
180 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
181 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
182 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
183 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
184 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
185 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
186 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
187 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...
188 Neuro-Ophthalmic Vascular DiseaseRobert F. Saul, MDIn image 93_29, taken during the episode, note the change in caliber of the blood vessels.
189 Neuro-Ophthalmic Vascular DiseaseRobert F. Saul, MDImage 93_30 is immediately after the attack, note the slight redness to the macula.
190 Neuro-Ophthalmic Vascular DiseaseRobert F. Saul, MDImage 93_28 shows the fundus before the attack.
191 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 23-year-old woman has had insulin-dependent diabetes mellitus since age 3. She was diagnosed with Sydenham's chorea in early childhood and had grand mal seizures from age 13 to 15. She has been hypertensive since age 18. Her vision was 20/25 OD and 20/40 OS, with dyschromatopsia OS, and a 1.8 l...
192 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 27-year-old woman had no past ocular history and presented with 3 weeks of redness OS that has been treated by the referring doctor as allergic conjunctivitis. She was referred for evaluation when she developed binocular diplopia. Her past medical history included phlebitis and one miscarriage ...
193 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
194 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
195 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis coronal CT scan shows the enlarged superior ophthalmic vein in the left orbit. This 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a ri...
196 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 23-year-old woman has had insulin-dependent diabetes mellitus since age 3. She was diagnosed with Sydenham's chorea in early childhood and had grand mal seizures from age 13 to 15. She has been hypertensive since age 18. Her vision was 20/25 OD and 20/40 OS, with dyschromatopsia OS, and a 1.8 l...
197 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 23-year-old woman has had insulin-dependent diabetes mellitus since age 3. She was diagnosed with Sydenham's chorea in early childhood and had grand mal seizures from age 13 to 15. She has been hypertensive since age 18. Her vision was 20/25 OD and 20/40 OS, with dyschromatopsia OS, and a 1.8 l...
198 Neuro-Ophthalmic Vascular DiseaseMark L. Moster, MDNeovascularization of the iris may form in response to an ischemic disease of the retina, such as diabetic retinopathy. Carotid artery occlusion may result in ocular ischemia that may induce neovascularization.This is a dramatic image of iris neovascularization.
199 Neuro-Ophthalmic Vascular DiseaseMark J. Kupersmith, MDAneurysms of the intracranial circulation may act as mass lesions and compress the afferent of efferent visual pathway. Ophthalmic artery aneurysms may compress the optic nerve and result in an optic neuropathy (ie, visual loss, afferent pupillary defect, optic atrophy). Treatment includes endovascu...
200 Neuro-Ophthalmic Vascular DiseaseMark J. Kupersmith, MDAneurysms of the intracranial circulation may act as mass lesions and compress the afferent of efferent visual pathway. Ophthalmic artery aneurysms may compress the optic nerve and result in an optic neuropathy (ie, visual loss, afferent pupillary defect, optic atrophy). Treatment includes endovascu...
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