11/36. Ectopic pituitary adenoma in the cavernous sinus causing oculomotor nerve paresis--case report.A 24-year-old woman presented with a rare adrenocorticotropic hormone (ACTH)-positive pituitary adenoma in the cavernous sinus, manifesting as sudden onset of oculomotor nerve paresis. neuroimaging revealed a tumor in the cavernous sinus bulging into the subdural space. There was no continuity between the tumor and the pituitary gland in the sella turcica. Gross total removal of the tumor was performed through the orbitozygomatic approach followed by stereotactic radiosurgery. The oculomotor nerve paresis was resolved. Histological examination revealed an adenoma positive for ACTH. Ectopic pituitary adenoma occurs mostly in the sphenoid sinus or the suprasellar region. This extremely rare case of ectopic macroadenoma in the cavernous sinus manifested as oculomotor nerve paresis without signs of Cushing's syndrome.- - - - - - - - - - ranking = 1keywords = pituitary, pituitary gland, gland (Clic here for more details about this article) |
12/36. A rare presentation of posterior communicating artery aneurysm.This is a report of a successfully treated case of a 55-year-old woman with posterior communicating artery aneurysm who had a partial 3rd nerve palsy with pupillary sparing, temporal lobe intracerebral hematoma and a subdural hematoma. Such an association has not been reported earlier.- - - - - - - - - - ranking = 1.9895627290538E-5keywords = lobe (Clic here for more details about this article) |
13/36. Oculomotor neuropathy syndrome. A diagnostic challenge in nasopharyngeal carcinoma.Of 22 patients with different kinds of oculomotor neuropathy syndrome (ONS), 18 were initially suspected of suffering from nasopharyngeal carcinoma (NPC). However, in a series of evaluations, their diagnoses eventually proved to be other diseases such as cranial neuritis, aneurysm of intracranial internal carotid artery, chordoma, etc. The remaining four patients initially diagnosed as having aneurysm of skull base or pituitary lesion were actually NPC sufferers. Therefore, one should be very careful in differentiating NPC from many other diseases contributing to the similar manifestation of ONS.- - - - - - - - - - ranking = 0.13646302032086keywords = pituitary (Clic here for more details about this article) |
14/36. Facial palsy as first presentation of acute myeloid leukemia.Granulocytic sarcoma or chloroma is a tumor composed of myeloblast or monoblast. These tumors may be found in any location of the body and occur in 5% of acute myeloid leukemia (AML) cases and are more common in pediatric patients. In this report we describe the case of a 27-year-old male who developed lower motor neuron seventh nerve palsy followed by swelling of the parotid gland. Fine-needle aspiration cytology (FNAC) of the soft tissue swelling revealed scattered blasts, and peripheral smear and bone marrow aspirate examination suggested AML. This is a rare presentation of a granulocytic sarcoma leading to a diagnosis of AML.- - - - - - - - - - ranking = 6.9945564693299E-5keywords = gland (Clic here for more details about this article) |
15/36. pituitary apoplexy presenting as unilateral third cranial nerve palsy after coronary artery bypass surgery.The new onset of pituitary apoplexy is a rare perioperative complication of coronary artery bypass surgery. A variety of clinical presentations of pituitary apoplexy have been reported including absence of clinical symptoms or headache, sudden deterioration of mental status, visual changes, Addisonian crisis, and ophthalmoplegia, including third cranial nerve palsy and/or ptosis. early diagnosis and treatment usually results in excellent outcome. We report a case of pituitary apoplexy that presented with only a unilateral dilated pupil, ptosis, and vision change within 3 h after coronary artery bypass surgery. The patient recovered fully after early pituitary tumor resection and hormonal therapy. IMPLICATIONS: Unilateral pupil dilation is a rare perioperative complication after coronary artery bypass surgery. We report a case of pituitary apoplexy that presented clinically as unilateral dilated pupil, ptosis, and visual loss shortly after coronary artery bypass surgery.- - - - - - - - - - ranking = 0.6823151016043keywords = pituitary (Clic here for more details about this article) |
16/36. Isolated oculomotor nerve palsy following apoplexy of a pituitary adenoma.An isolated oculomotor nerve palsy is very rarely the presenting sign of a pituitary adenoma. It may occur slowly due to mechanical compression or rapidly, secondary to pituitary apoplexy. magnetic resonance imaging (MRI) with and without gadolinium dtpa enhancement provides excellent anatomical detail and is useful in the planning of the operative procedure. When correctly diagnosed and treated, the third nerve dysfunction appears to be reversible. We report a case of a pituitary adenoma presenting with an isolated, partial oculomotor nerve palsy in the setting of apoplexy. The pathophysiology, prognostic factors and MRI findings of this entity are discussed.- - - - - - - - - - ranking = 0.95524114224601keywords = pituitary (Clic here for more details about this article) |
17/36. Transsphenoidal diplopia.A 46-year-old man developed a pupil-involving incomplete third cranial nerve palsy after undergoing transsphenoidal resection of a pituitary macroadenoma. A CT scan 1 week later revealed postoperative changes, with no new mass lesion, hemorrhage, or orbital fracture. The third cranial nerve palsy spontaneously improved over the ensuing week. Postoperative ocular motor palsy is an uncommon complication of transsphenoidal pituitary surgery. Neuro-imaging should be performed to exclude the presence of a new compressive lesion.- - - - - - - - - - ranking = 0.27292604064172keywords = pituitary (Clic here for more details about this article) |
18/36. A new surgical technique for ocular fixation in congenital third nerve palsy.PURPOSE: To present a new technique of ocular fixation to restore and maintain the ocular alignment in primary position for patients with total third nerve paralysis. METHOD: We fixated the globe (medial rectus muscle insertion) to the medial palpebral ligament insertion at the anterior lacrimal crest by using nonabsorbable 5-0 polyester sutures in a prospective study of 5 patients (5 eyes) with congenital total third nerve paralysis. A large recession of the lateral rectus muscle (12 to 16 mm) was also performed in four patients. RESULTS: Four patients achieved satisfactory ocular alignment and one patient had residual exotropia. After an initial exotropic shift, no significant change in ocular alignment was observed during the follow-up period of 6 to 9 months. Mild fullness and congestion over the medial rectus muscle area was observed in the immediate postoperative period in all the patients, which resolved in about two months time. CONCLUSION: This technique of ocular fixation is easy, safe, and effective for the management of exotropia secondary to total third nerve paralysis.- - - - - - - - - - ranking = 1.9895627290538E-5keywords = lobe (Clic here for more details about this article) |
19/36. Rectus muscle orbital wall fixation: a reversible profound weakening procedure.INTRODUCTION: Surgical treatment of third nerve palsy, sensory exotropia and strabismus secondary to anomalous innervation of the rectus muscles, frequently require large rectus muscle recessions in an attempt to maintain alignment in the primary position and reduce the effects of misinnervation. The aim of this study was to describe and evaluate the results of inactivation of a rectus muscle by its attachment to the adjacent orbital wall. methods: Seven subjects diagnosed with third-nerve palsy (three cases), Duane syndrome (two cases), sensory exotropia (one case), and congenital aberrant innervation of vertical rectus muscles (one case) underwent rectus muscle inactivation by orbital wall fixation. The rectus muscle was disinserted from the globe and reattached to the adjacent orbital periosteum using non-absorbable sutures. This surgery was performed on the lateral rectus muscle in six subjects, and surgery was performed on both ipsilateral vertical rectus muscles in one. RESULTS: Postoperatively four of six patients were aligned within 12 prism diopters of orthotropia in primary position. All patients had improvement of the anomalous head posture. In Duane syndrome, lateral rectus inactivation markedly reduced co-contraction and globe retraction. No overcorrections resulted. CONCLUSION: A rectus muscle may be functionally inactivated when its insertion is attached to the orbital periosteum. Advantages of this procedure over extirpation and free tenotomy include permanent disinsertion of the muscle from globe and reversibility.- - - - - - - - - - ranking = 5.9686881871616E-5keywords = lobe (Clic here for more details about this article) |
20/36. An adjustable medial orbital wall suture for third nerve palsy.A 16-year-old girl presented with a large-angle exotropia due to congenital third nerve palsy. She had undergone recession/resection surgery as a child. A nasal transposition of the superior oblique and the lateral rectus produced some improvement but the result was still cosmetically unacceptable. Subsequent surgery to permanently secure the globe to the medial orbital wall using an intraoperatively adjustable nonabsorbable traction suture produced a satisfactory outcome.- - - - - - - - - - ranking = 1.9895627290538E-5keywords = lobe (Clic here for more details about this article) |
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