1/10. optic nerve lesion following neuroborreliosis: a case report.PURPOSE: Neuroborreliosis may cause various neuro-ophthalmological complications. We describe a case with a bilateral optic neuropathy. CASE REPORT: A 58-year-old female developed facial paresis six weeks after an insect bite. One week later she developed bilateral optic disc swelling with haemorrhages and nerve fibre bundle defects in the lower visual field of the left eye. In CSF and serum, raised IgM and IgG titres to borrelia burgdorferi were found. Systemic antibiotic treatment led to improvement of the vision and facial paresis, but not all visual field defects resolved, probably due to ischemic lesions of the optic disc. DISCUSSION/CONCLUSIONS: In optic nerve lesions due to neuroborreliosis it is difficult to distinguish between inflammatory and ischemic lesions. This patient demonstrated features of an ischemic optic nerve lesion.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/10. Splitting and penetration of the optic nerve by an aneurysm arising from the anterior wall of internal carotid artery: case report.Aneurysms arising from the anterior wall of the internal carotid artery (ICA) are uncommon. There have not been any reports demonstrating the anatomical relation of such aneurysms to the optic nerve. An aneurysm arising from the anterior wall of the ICA splitting and penetrating the optic nerve is reported. A 73 year old woman presented with severe headache due to subarachnoid haemorrhage. She had never experienced a visual disturbance. At surgery, the aneurysm was shown to arise from the anterior wall of the left internal carotid artery and to split and penetrate the left optic nerve. The aneurysm was not related to arterial bifurcation of any branches and was safely neck clipped. Given the evidence of a split and penetration of the optic nerve, the pathogenesis of such an aneurysm may be due to the persistence of an embryonic vessel.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
3/10. Acute retrobulbar optic neuropathy due to rupture of an anterior communicating artery aneurysm.PURPOSE: The vast majority of ruptured aneurysms of the anterior communicating artery typically present with subarachnoid haemorrhage. Isolated visual complaints are very uncommon in this setting. We present an unusual case of a patient with an acute retrobulbar optic neuropathy, secondary to a ruptured anterior communicating artery aneurysm. DESIGN: Observational case report. methods: A 29-year-old woman was assessed for an acute, isolated unilateral optic neuropathy of unknown origin. Although an initial encephalic MRI was believed to be normal, an underlying ruptured anterior communicating artery aneurysm was eventually diagnosed when the patient became stuporous because of intracranial bleeding. CONCLUSIONS: Occurrence of an acute retrobulbar optic neuropathy may be the initial isolated sign related to a ruptured anterior communicating artery aneurysm, prompting an appropriate neuroradiological assessment.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/10. A subhyaloid haemorrhage as the presenting symptom of bilateral optic neuropathy.A 28 year-old man with a spontaneous vitreous haemorrhage as the first sign of Leber's optic atrophy is presented. The blood collected in a central retrohyaloid area covering the left macula. The exact starting point of the haemorrhage was never positively identified, but it seemed to originate from an area of microangiopathy adjacent to the optic disc. For 8-10 months the vision of the left eye gradually decreased to counting fingers. A year later the visual acuity dropped to the same level on the right eye. The picture was compatible with Leber's optic atrophy. Other disorders causing bilateral optic neuropathy were excluded. A careful family history revealed several cases of visual problems for several generations. Vitreous haemorrhage as the first sign of Leber's optic atrophy has not previously been reported. Peripapillar microangiopathy, however, has been described in the asymptomatic stage of the disease.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
5/10. Haemorrhage in the lens: spontaneous occurrence in congenital cataract.A 2-month-old female infant had bilateral congenital cataract. In the left eye a blood clot was situated on the subcapsular polar cataract. An uneventful lensectomy combined with anterior vitrectomy by the pars plicata approach revealed remnants of the posterior portion of hyaloid artery on the optic nerve head. It is likely that the spontaneous and long-lasting haemorrhage in the lens had been caused by rupture of the anterior end of the hyaloid artery attached to the posterior lens surface and had occurred in the late prenatal or early postnatal period.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/10. Retinal complications of optic disc drusen.Following reports by Sanders et al. and Wise et al. of optic disc drusen associated with retinal bleeding, an additional 19 cases were studied and followed up for 1 to 10 years (average 5 years). Four of them showed haemorrhages at the optic disc and its borders only, but 15 showed extensive retinopathy with macular involvement. In 3 cases retinopathy was serous and not haemorrhagic. Apart from cases in which bleeding was limited to the disc and its immediate vicinity the main clinical features of the syndrome were as follows: (1) the presence of optic disc drusen; (2) extensive retinal haemorrhage; (3) intraretinal extravasation of serum with or without the presence of blood; (4) elevated mounds lifting the retina and causing striae radiating from the mounds towards the macula and beyond; (5) pigmentary disturbance of the macula or a wider area of papillo-macular bundle after the resolution of acute stages which, while often clinically severe, is compatible with recovery of normal or near normal vision. It is proposed that the syndrome be designated the 'optic disc drusen retinopathy.'- - - - - - - - - - ranking = 8.2385926625689keywords = retinal haemorrhage, haemorrhage (Clic here for more details about this article) |
7/10. Ischaemic optic neuropathy--a combined mechanism.A clinical pathological study is reported of a patient who developed bilateral ischaemic optic neuropathy following a massive gastrointestinal haemorrhage with associated vascular complications in watershed areas of the myocardium and brain. Additional factors of giant cell arteritis and diabetic ketoacidosis contributed to the unique pathology. The distribution of infarction to the optic nerve has been related to known studies on the blood supply of the optic nerve.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/10. optic nerve granuloma as first sign of systemic sarcoidosis.We report a rare casse of optic nerve involvement as the first sign of systemic sarcoidosis. A 43-year-old white woman presented with visual loss in her right eye, and the clinical appearance of optic nerve head swelling. visual acuity was reduced to 20/200, and the only clinical signs were the presence of an enlarged optic nerve head, with engorged retinal veins and flame-shaped haemorrhages. Computed tomography scans showed an enlarged orbital portion of the right optic nerve, which was confirmed by magnetic resonance imaging. With a diagnosis of optic nerve tumour (possibly glioma) a surgical resection of the tumour was performed. Histopathology showed multiple nodular granulomas with epithelioid cells, consisted with the diagnosis of sarcoidosis. This was confirmed by systemic involvement of the parotids and liver. We review the literature and consider all possible involvement of the optic nerve in sarcoidosis. The rarity of systemic sarcoidosis with a first manifestation as papilloedema is discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
9/10. Cavernous malformations of the optic chiasma.Two cases of cavernous malformation of the optic chiasm are reported, and 12 previously reported cases are reviewed. The first patient presented with gradually progressive and the second patient with a subacute chiasmal syndrome. Total excision was performed in both cases. Visual function improved slightly after surgery in the first patient while the other showed marked improvement. Although cavernous malformations are angiographically occult, pre-operative diagnosis has become possible based on the characteristic features such as repeated haemorrhages in multiple sinusoidal structures as revealed by magnetic resonance imaging (MRI). A gliotic interspace between the malformation and normal neural tissue provides a plane of cleavage for dissection which permits total excision without causing new deficits. review of previously reported cases revealed that chiasmal cavernous malformations haemorrhage more frequently than those in the brain. early diagnosis with total excision is the treatment of choice for cavernous malformations of the optic chiasma.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
10/10. Traumatic haemorrhagic optic neuropathy: case report.We report a case of visual loss following haemorrhage into the optic nerve sheath following head trauma. The patient showed improvement in visual function following decompression of the optic nerve sheath and evacuation of the haematoma.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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