In order to understand this, you must first know that optic nerve (CN II) afferent input from either eye will cause a bilateral efferent response via the oculomotor nerve (CN III), causing both eyes to constrict. In reality, it doesn’t dilate it just doesn’t constrict as much as the unaffected side. In RAPD, shining a light in the eyes and moving it side to side will make it appear as though the affected eye’s pupil dilates, rather than constricts, in response to light. Optic neuritis causes a Marcus Gunn pupil, which is also known as a relative afferent pupillary defect (RAPD). Essentially in the vignette they’ll say a woman 20s to 30s who has an episode of blurry vision + urge incontinence + other sensory or motor dysfunction –> answer = MS with optic neuritis. Optic neuritis literally means inflammation of the optic nerve –> classically seen in multiple sclerosis –> can present with a wide array of visual changes, e.g., blurry vision, loss of color vision, and central scotoma. Treatment for diabetic retinopathy is with injections of VEGF inhibitors or laser photocoagulation. HTN is the other common cause of cotton wool spots. In addition, they can also grow into the vitreous humor, eventually leading to vitreous hemorrhage.Ĭotton wool spots may be seen on fundoscopy, which are axonoplasmic aggregates from neuronal degeneration. The tiny new blood vessels are fragile and can easy rupture, causing blindness. Initially it is non-proliferative, meaning there is no neovascularization of the retina, and many patients won’t notice any visual changes.Īs retinal ischemia progresses, neovascularization occurs this is called proliferative diabetic retinopathy. Our results support the fact that embolism resulted from large artery atherosclerosis is the important stroke mechanism in the BCI.Caused by non-enzymatic glycosylation of retinal microvessels –> vascular damage with degeneration of capillaries –> reduced retinal blood flow + ischemia + damage to neurons of inner retina. Offending artery diseases are mainly in the V4 segment of the vertebral artery, and in the severe stenosis or occlusion of V4 and BA junction.ĬONCLUSIONS: BCI was frequently involved in the PICA + SCA territory. Merged infratentorial lesions are more common (p = 0.022) than BCI with atherosclerosis (p = 0.041). The incidence rate of BCI merged with CLOC is much higher than the unilateral cerebellar infarct (p = 0.002). Unilateral cerebellar infarct occurs more often (p = 0.006) BCI is more common in PICA+SCA blood supplying territory (p = 0.004). The incidence rate of cerebellar infarct in a posterior inferior cerebellar artery (PICA) blood supplying territory is the highest by divisions of vascular distribution. The baseline information shows that stroke history (p = 0.002), fibrinogen (p = 0.036) and admission NIHSS score (M) (p = 0.001) for the BCI group are higher than the unilateral cerebellar infarct group. There were 36 (64.3%) cases of unilateral cerebellar infarct and 20 (35.7%) cases of the BCI. RESULTS: Amongst the 115 patients hospitalized with posterior circulation cerebral infarct due to acute stroke, 56 patients had cerebellar infarct. The demographic features, involved territories and concomitant lesions outside the cerebellum (CLOC). Patients were divided into two groups by lesions: unilateral cerebellar infarct (UCI) and bilateral cerebellar infarct (BCI). PATIENTS AND METHODS: Patients admitted to Xiangyang Hospital with acute cerebellar infarcts, confirmed by diffusion-weighted imaging (DWI), were investigated. OBJECTIVE: To explore the lesion patterns and stroke mechanism of the acute bilateral cerebellar infarct.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |