Neuro-vascular Neuro-ophthalmology

Neuro-vascular Neuro-ophthalmology

by Mark J. Kupersmith

Paperback(Softcover reprint of the original 1st ed. 1993)

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Overview

Neuro-ophthalmological symptoms frequently arise in disorders which alter the intracranial and intraorbital circulation. Because of the wide range of sensory and cognitive systems involved in vision and eye movements,
visual disturbances are typically found in the common vascular disorders, such as atherosclerosis, migraine, and aneurysms, but can also result from practically any, common or rare,local or systemic vascular disorder. The dysfunction can be part of a largersyndrome or the predominant clinical abnormality. Many of the newer concepts concerning the diagnosis and treatment of neurovascular disorders have evolved in consequence of advances in techniques for neuroimaging such as MRI; methods of measuring systemic coagulation and inflammation; and superselective catheterization ofabnormal blood vessels and vascular lesions. The neuroophthalmological evaluation of clinical signs and symptoms often leads to accurate localization and diagnosis of the lesion. Many of these clinical abnormalities, such as visual field defects and ocular misalignments, can be quantified and followed to assess either the natural history of the disorder or the effects of therapies.
No one medical specialty can manage these neurovascular neuro-ophthalmological disorders alone. The complexity of diagnosis and treatment planning requires a multi-
disciplinary team. This approach, bringing ophthalmologists,
neurosurgeons, and neurologists together to confer in the management of these cases, has been pioneered by the authors' group at the New York University Medical Center.

Product Details

ISBN-13: 9783642776229
Publisher: Springer Berlin Heidelberg
Publication date: 12/16/2011
Edition description: Softcover reprint of the original 1st ed. 1993
Pages: 554
Product dimensions: 7.60(w) x 10.63(h) x (d)

Table of Contents

1 Circulation of the Eye, Orbit, Cranial Nerves, and Brain.- 1.1 Introduction.- 1.2 Carotid Arterial System.- 1.2.1 Common Carotid Artery.- 1.2.2 External Carotid Arterial System.- 1.2.3 Internal Carotid Artery System.- 1.2.4 Cerebral Arteries.- 1.3 Vertebrobasilar Arterial System.- 1.3.1 Vertebral and Basilar Arteries.- 1.3.2 Posterior Cerebral Artery.- 1.4 Intracranial Venous Drainage.- 1.4.1 Supratentorial Deep and Superficial Venous Systems.- 1.4.2 Venous Drainage of the Posterior Fossa.- 1.5 Circulation in Regions of Neuro-ophthalmologic Importance.- 1.5.1 Orbital Circulation.- 1.5.2 Sensory Visual Pathway Circulation.- 1.5.3 Efferent Pathway Circulation.- 1.6 Cerebral Blood Flow Physiology.- 2 Carotid Cavernous Fistulas.- 2.1 Epidemiology and Causes.- 2.1.1 Trauma.- 2.1.2 Spontaneous Carotid Cavernous Fistulas.- 2.2 Clinical Presentation, Evaluation, and Differential Diagnosis.- 2.2.1 Symptoms and Signs.- 2.2.2 Red Eye Differential Diagnosis.- 2.2.3 Venous Ischemic-Hypoxic Retinopathy: Differential Diagnosis.- 2.2.4 Orbital Bruit Differential Diagnosis.- 2.3 Laboratory Evaluation.- 2.3.1 Ultrasonography.- 2.3.2 Computed Tomography.- 2.3.3 Magnetic Resonance Imaging.- 2.3.4 Angiography.- 2.4 Therapy.- 2.4.1 Visual Loss, Cranial Neuropathy.- 2.4.2 Glaucoma.- 2.4.3 Corneal Abnormalities.- 2.4.4 Manual Copression of the Internal Carotid Artery.- 2.4.5 Emergency Treatment.- 2.4.6 Surgery.- 2.4.7 Embolization.- 2.4.8 Management of Associated Injuries.- 2.4.9 Results and Complications.- 2.4.10 Therapy Is Not Always Warranted.- 3 Neuro-ophthalmic Manifestations of Intracranial Dural Venous Disorders.- 3.1 Introduction.- 3.2 Dural Arteriovenous Malformations and Shunts.- 3.2.1 Epidemiology.- 3.2.2 Clinical Features.- 3.2.3 Mechanisms of Dysfunction of Durai Arteriovenous Malformations.- 3.2.4 Pathology and Etiology.- 3.2.5 Neuroimaging.- 3.2.6 Therapy and Course.- 3.2.7 Durai Arteriovenous Malformation of the Cavernous Sinus Area.- 3.3 Dural Venous Sinus Thrombosis.- 3.3.1 Introduction.- 3.3.2 Cavernous Sinus Thrombosis.- 3.3.3 Superior Sagittal Sinus Thrombosis.- 3.3.4 Lateral Sinus Thrombosis.- 3.3.5 Thrombosis in Other Durai Sinuses.- 3.3.6 Mechanical Occlusion of the Dural Venous Sinuses.- 4 Orbital Vascular Lesions.- 4.1 Introduction.- 4.2 Clinical Evaluation of Patients with Orbital Disease.- 4.3 Imaging of Orbital Lesions.- 4.3.1 Computed Tomography.- 4.3.2 Magnetic Resonance Imaging.- 4.3.3 Ultrasonography.- 4.3.4 Angiography.- 4.3.5 Venography.- 4.4 Orbital Varix.- 4.4.1 Clinical Manifestations.- 4.4.2 Histopathology.- 4.4.3 Imaging.- 4.4.4 Course and Treatment.- 4.5 Arteriovenous Malformation.- 4.5.1 Clinical Manifestations.- 4.5.2 Histopathology.- 4.5.3 Imaging.- 4.5.4 Treatment.- 4.6 Capillary Hemangioma.- 4.6.1 Clinical Manifestations.- 4.6.2 Histopathology.- 4.6.3 Imaging.- 4.6.4 Treatment.- 4.7 Cavernous Hemangioma (Cavernoma).- 4.7.1 Clinical Manifestations.- 4.7.2 Histopathology.- 4.7.3 Imaging.- 4.7.4 Treatment.- 4.8 Lymphangioma.- 4.8.1 Clinical Manifestations.- 4.8.2 Histopathology.- 4.8.3 Imaging.- 4.8.4 Treatment.- 4.9 Hemangiopericytoma.- 4.9.1 Clinical Manifestations.- 4.9.2 Histopathology.- 4.9.3 Imaging.- 4.9.4 Treatment.- 4.10 Malignant Hemangioendothelioma.- 4.10.1 Clinical Manifestations.- 4.10.2 Histopathology.- 4.10.3 Imaging.- 4.10.4 Treatment.- 4.11 Leiomyoma.- 4.11.1 Clinical Manifestations.- 4.11.2 Histopathology.- 4.11.3 Imaging.- 4.11.4 Treatment.- 4.12 Vascular Tumors of the Sphenoid Wing and the Cavernous Sinus.- 4.12.1 Meningioma.- 4.12.2 Fibrous Dysplasia.- 4.12.3 Hemangiopericytoma.- 4.13 Vascular Phakomatoses (Neurocutaneous Syndromes).- 4.13.1 Sturge-Weber Syndrome (Encephalotrigeminal Angiomatosis).- 4.13.2 Von Hippel-Lindau Disease (Retinocerebellar Angiomatosis).- 4.13.3 Wyburn-Mason Syndrome.- 4.13.4 Klippel-Trenaunay-Weber Syndrome.- 4.13.5 Osler-Weber-Rendu Syndrome (Hereditary Hemorrhagic Telangiectasia).- 4.14 Cavernous Hemangioma of the Brain and Retina.- 5 Vascular Optic Neuropathies.- 5.1 Anterior Ischemic Optic Neuropathy.- 5.1.1 Clinical Presentation.- 5.1.2 Clinical Course.- 5.1.3 Risk Factors.- 5.1.4 Cataract Surgery.- 5.1.5 Emboli.- 5.1.6 Differential Diagnosis of Unilateral Visual Loss and Optic Disc Swelling.- 5.1.7 Pathology and Localization of the Ischemic Process.- 5.1.8 Laboratory and Systemic Disease Evaluation.- 5.1.9 Treatment.- 5.2 Giant-Cell Arteritis.- 5.2.1 Clinical Presentation.- 5.2.2 Clinical Examination.- 5.2.3 Laboratory Evaluation.- 5.2.4 Temporal Artery Biopsy.- 5.2.5 Pathophysiology.- 5.2.6 Ocular Pathology.- 5.2.7 Treatment and Course.- 5.3 Papilledema.- 5.3.1 Ophthalmologic Findings.- 5.3.2 Mechanisms of Visual Disturbance.- 5.4 Leber’s Optic Neuropathy.- 5.4.1 Molecular Aspects.- 5.4.2 Cardiac and Neurologic Abnormalities.- 5.4.3 Ophthalmologic Findings and Clinical Course.- 5.4.4 Treatment.- 5.5 Postshock Optic Neuropathy.- 5.5.1 Causes.- 5.5.2 Ophthalmologic Findings.- 5.6 Low-Tension Glaucoma.- 5.6.1 Ophthalmologic Findings.- 5.6.2 Pathogenesis.- 5.6.3 Differential Diagnosis.- 5.6.4 Treatment and Course.- 5.7 Juvenile Diabetes Mellitus.- 5.8 Optic Disc Vasculities or Papillophlebitis.- 5.8.1 Differential Diagnosis.- 5.8.2 Pathology.- 5.8.3 Diagnostic Evaluation.- 5.8.4 Treatment.- 5.9 Posterior Ischemic Optic Neuropathy.- 5.10 Rare Causes of Ischemic Optic Neuropathy.- 5.11 Radiation Damage to the Eye and Brain.- 5.11.1 Introduction.- 5.11.2 Radiation Retinopathy.- 5.11.3 Radiation Optic Nerve and Chiasm Neuropathy.- 5.11.4 Retrochiasmal Radiation Damage.- 5.11.5 Arterial Occlusive Disease.- 5.11.6 Nonvascular Complications.- 5.11.7 Treatment.- 6 Aneurysms Involving the Motor and Sensory Visual Pathways.- 6.1 General Discussion.- 6.1.1 Introduction.- 6.1.2 Incidence.- 6.1.3 Etiology.- 6.1.4 Rupture.- 6.1.5 Rebleed.- 6.1.6 Morbidity and Mortality.- 6.1.7 Neuro-ophthalmologic Symptoms and Signs.- 6.1.8 Neuroimaging.- 6.1.9 Cerebrospinal Fluid.- 6.1.10 Therapy and Course.- 6.2 Carotid Cavernous Aneurysm.- 6.2.1 Incidence and Differential Diagnosis.- 6.2.2 Clinical Presentation and Neuro-opthalmologic Dysfunction.- 6.2.3 Differential Diagnosis of Painful Ophthalmoplegia.- 6.2.4 Neuroimaging.- 6.2.5 Treatment and Course.- 6.3 Posterior Communicating Artery Aneurysm.- 6.3.1 Incidence.- 6.3.2 Clinical Presentation.- 6.3.3 Neuroimaging.- 6.3.4 Therapy and Outcome.- 6.4 Carotid-Ophthalmic Artery Aneurysm.- 6.4.1 Incidence.- 6.4.2 Clinical Presentation.- 6.4.3 Neuroimaging.- 6.4.4 Treatment and Course.- 6.5 Aneurysm of the Internal Carotid Artery Bifurcation.- 6.5.1 Incidence.- 6.5.2 Clinical Presentation.- 6.5.3 Neuroimaging.- 6.5.4 Treatment and Course.- 6.6 Anterior Communicating Artery Aneurysm.- 6.6.1 Incidence.- 6.6.2 Clinical Presentation.- 6.6.3 Neuroimaging.- 6.6.4 Therapy and Outcome.- 6.7 Basilar Artery Aneurysm.- 6.7.1 Incidence.- 6.7.2 Clinical Presentation.- 6.7.3 Neuroimaging.- 6.7.4 Treatment and Course.- 6.8 Other Posterior Circulation Aneurysms.- 6.9 Nonsaccular Aneurysms.- 6.9.1 Fusiform Aneurysms.- 6.9.2 Traumatic Aneurysms.- 6.9.3 Mycotic Aneurysms.- 7 Vascular Malformations of the Brain.- 7.1 Arteriovenous Malformations.- 7.1.1 Introduction.- 7.1.2 Incidence.- 7.1.3 Presentation.- 7.1.4 Hemodynamics: Controversies and Unresolved Questions.- 7.1.5 Hemodynamics: Clinical Features.- 7.1.6 Posterior Fossa Brain Arteriovenous Malformations: Special Circumstances.- 7.1.7 Vein of Galen Malformations.- 7.1.8 Long-Term Follow-up of Brain Arteriovenous Malformations.- 7.1.9 Radiographic Evaluation.- 7.1.10 Specific Visual Sensory or Ocular Motor Abnormalities Related to Brain Arteriovenous Malformations.- 7.1.11 Treatment.- 7.2 Other Vascular Lesions of the Brain.- 7.2.1 Telangiectasia.- 7.2.2 Cavernoma (Cavernous Hemangioma).- 7.2.3 Venous Vascular Anomalies (Venous Angioma).- 8 Embolic and Noninflammatory Occlusive Vascular Disease of the Visual and Ocular Motor Systems.- 8.1 Introduction.- 8.2 Ocular Ischemia.- 8.2.1 Intraocular Ischemic Alterations.- 8.2.2 Other Signs of Ocular Ischemia.- 8.2.3 Embolie Ocular Disease.- 8.2.4 Relationship of Ocular Ischemic Events to Carotid and Cardiac Disease.- 8.2.5 Syndrome of Ischemic Oculopathy.- 8.3 Carotid and Cardiac Evaluation.- 8.3.1 Bruit.- 8.3.2 Ophthalmodynamometry.- 8.3.3 Ocular Pneumoplethysmography.- 8.3.4 Carotid Ultrasonography and Thermography.- 8.3.5 Angiography.- 8.3.6 Cardiac Evaluation.- 8.3.7 Differential Diagnosis of Cerebrovascular Occlusive Disease.- 8.4 Aortic Arch Occlusive Disease.- 8.5 Neuro-ophthalmologic Disorders Caused by Brain Infarcts.- 8.5.1 Sensory Visual Disturbances.- 8.5.2 Efferent Pathway Disturbances.- 8.6 Therapeutic Considerations.- 8.6.1 Cardiac Disease.- 8.6.2 Carotid Atherosclerosis.- 8.6.3 Antiplatelet Agents.- 8.6.4 Anticoagulation.- 8.6.5 Surgery.- 8.6.6 Antihypertensives.- 8.6.7 Posterior Circulation.- 8.6.8 Treatment of Ocular Ischemic Conditions.- 8.7 Atypical Occlusive Disease of the Ophthalmic Artery.- 8.8 Ischemic Cranial Nerve Syndromes.- 8.8.1 Introduction.- 8.8.2 Third Cranial Nerve Vascular Neuropathy.- 8.8.3 Sixth Cranial Nerve Vascular Neuropathy.- 8.8.4 Fourth Cranial Nerve Vascular Neuropathy.- 8.8.5 Ischemia of Multiple Cranial Nerves.- 8.9 Fibromuscular Dysplasia.- 8.10 Moyamoya Disease.- 8.11 Hypercoagulation Disorders.- 8.11.1 Systemic Malignancy.- 8.11.2 Primary Coagulation System Deficiencies.- 8.11.3 Cerebral Venous Thrombosis.- 8.12 Dissection of the Carotid and Vertebral Arteries.- 8.12.1 Traumatic Dissection of the Cervical Carotid Artery.- 8.12.2 Spontaneous Dissection of the Internal Carotid Artery.- 8.12.3 Dissection of the Vertebral Artery.- 8.13 Metabolic Disorders Associated with Cerebral Vaso-occlusive Disease.- 8.13.1 Homocystinuria.- 8.13.2 MELAS Syndrome.- 8.13.3 Fabry’s Disease.- 8.14 Specific Retinal Disorders.- 8.14.1 Arteriolar and Capillary Occlusive Disease.- 8.14.2 Venous Disease.- 9 Inflammatory Vascular Disorders of the Brain and Eye.- 9.1 Introduction.- 9.2 Giant Cell Arteritis (Temporal Arteritis).- 9.3 Polyarteritis Nodosa.- 9.3.1 Incidence and Systemic Involvement.- 9.3.2 Neurologic Manifestations.- 9.3.3 Ophthalmologic and Neuro-ophthalmologic Manifestations.- 9.3.4 Neuroimaging.- 9.3.5 Pathology.- 9.3.6 Laboratory Evaluation.- 9.3.7 Treatment and Course.- 9.4 Systemic Lupus Erythematosus.- 9.4.1 Incidence and Systemic Involvement.- 9.4.2 Neurologic Manifestations.- 9.4.3 Ophthalmologic and Neuro-ophthalmologic Manifestations.- 9.4.4 Neuroimaging.- 9.4.5 Pathology.- 9.4.6 Laboratory Evaluation.- 9.4.7 Treatment and Course.- 9.5 Rheumatoid Arthritis.- 9.5.1 Incidence.- 9.5.2 Neurologic Manifestations.- 9.5.3 Ophthalmologic and Neuro-ophthalmologic Manifestations.- 9.5.4 Laboratory Evaluation.- 9.5.5 Treatment.- 9.6 Wegener’s Granulomatosis.- 9.6.1 Incidence and Systemic Involvement.- 9.6.2 Neurologic Manifestations.- 9.6.3 Ophthalmologic and Neuro-ophthalmologic Manifestations.- 9.6.4 Laboratory Evaluation and Pathology.- 9.6.5 Treatment and Course.- 9.7 Behçet’s Syndrome.- 9.7.1 Incidence and Systemic Involvement.- 9.7.2 Neurologic Manifestations.- 9.7.3 Ophthalmologic and Neuro-ophthalmologic Manifestations.- 9.7.4 Laboratory Evaluation and Neuroimaging.- 9.7.5 Treatment and Course.- 9.8 Granulomatous Angiitis Confined to the Central Nervous System.- 9.8.1 Neurologic Manifestations.- 9.8.2 Differential Diagnosis.- 9.8.3 Neuroimaging.- 9.8.4 Pathology.- 9.8.5 Laboratory Evaluation.- 9.8.6 Treatment and Course.- 9.9 Central Nervous System Angiitis of Other Causes.- 9.9.1 Herpes Zoster.- 9.9.2 Relapsing Polychondritis.- 9.9.3 Allergic Granulomatous Angiitis (Churg-Strauss Syndrome).- 9.9.4 Substance Abuse.- 9.10 Takayasu’s Arteritis.- 9.10.1 Incidence and Systemic Involvement.- 9.10.2 Neurologic and Neuro-ophthalmologic Manifestations.- 9.10.3 Imaging.- 9.10.4 Pathology.- 9.10.5 Laboratory Evaluation.- 9.10.6 Treatment.- 9.11 Cogan’s Syndrome.- 9.11.1 Incidence and Systemic Involvement.- 9.11.2 Neurologic and Neuro-ophthalmologic Manifestations.- 9.11.3 Treatment.- 9.12 Lymphatoid Granulomatosis.- 9.12.1 Incidence and Systemic Involvement.- 9.12.2 Neurologic and Neuro-ophthalmologic Manifestations.- 9.12.3 Laboratory Evaluation and Pathology.- 9.12.4 Treatment.- 9.13 Microangiopathy of the Retina and Brain.- 9.13.1 Ophthalmologic and Neurologic Manifestations.- 9.13.2 Differential Diagnosis.- 9.13.3 Laboratory Evaluation.- 9.13.4 Treatment.- 9.14 Eales’ Disease (Periphlebitis Retinae).- 9.15 Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Cerebral Vasculities.- 9.15.1 Treatment and Course.- 9.16 Sjögren’s Syndrome.- 9.16.1 Incidence and Systemic Involvement.- 9.16.2 Neurologic Manifestations.- 9.16.3 Neuro-ophthalmologic Manifestations.- 9.16.4 Laboratory Evaluation.- 9.16.5 Neuroimaging.- 9.16.6 Treatment.- 9.17 Occlusive Disease Associated with Antiphospholipid Antibody Syndromes: A Disorder in Evolution.- 9.17.1 Treatment.- 10 Migraine.- 10.1 Introduction and Epidemiology.- 10.2 Types of Migraine.- 10.2.1 Classic Migraine.- 10.2.2 Common Migraine.- 10.2.3 Positive Visual Disturbances in Classic and Common Migraine.- 10.2.4 Complicated Migraine.- 10.2.5 Ophthalmoplegic Migraine.- 10.2.6 Acephalgic Migraine.- 10.2.7 Other Headaches with Possible Vascular Dysfunction.- 10.3 Theories of the Causes of Migraine.- 10.3.1 Neurotransmitter Maintenance and Altered Vasomotor Tone.- 10.3.2 Neuronal Dysfunction.- 10.3.3 Spreading Depression.- 10.3.4 Platelet Hyperaggregability.- 10.3.5 Hormonal Influences.- 10.3.6 Psychological Factors.- 10.3.7 Blood-Brain Barrier Alteration and Dietary Factors.- 10.3.8 Allergy.- 10.3.9 Trauma.- 10.4 Theories of Visual and Neurologic Phenomena.- 10.4.1 Positive Phenomena.- 10.4.2 Negative Phenomena.- 10.4.3 Permanent Neurologic or Visual Defects.- 10.5 Mechanisms of Headache.- 10.6 Laboratory Evaluation.- 10.7 Treatment.- 10.7.1 Acute Episodic Headache Management.- 10.7.2 Prophylaxis.- 10.7.3 Formerly Used Agents.- 10.7.4 Complicated Migraine Treatment.- References.

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