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Brain Tumor Research and Treatment Apr 2022Optic pathway glioma (OPG) is a rare tumor located in optic nerve, optic tract, or optic chiasm. Treatment options for OPG include surgery, radiation therapy (RT), and... (Review)
Review
Optic pathway glioma (OPG) is a rare tumor located in optic nerve, optic tract, or optic chiasm. Treatment options for OPG include surgery, radiation therapy (RT), and chemotherapy. Although RT may provide favorable long-term outcomes in manner of either adjuvant or salvage aim, chemotherapy-first approach is increasingly performed due to possible late effects of RT. Proton beam RT may allow normal tissue sparing of radiation exposure compared to conventional X-ray treatment. Therefore, proton beam RT is expected to reduce complications from RT. This review discusses the recent updates on oncologic outcomes of OPG, late toxicities following RT, and compares the outcomes between X-ray treatment and proton beam RT.
PubMed: 35545828
DOI: 10.14791/btrt.2022.0003 -
Journal of Neurology, Neurosurgery, and... Aug 2006To describe the characteristics of patients with homonymous hemianopia from traumatic brain injury (TBI) seen in our unit between 1989 and 2004.
OBJECTIVE
To describe the characteristics of patients with homonymous hemianopia from traumatic brain injury (TBI) seen in our unit between 1989 and 2004.
METHODS
Only patients with a history of TBI, who had detailed clinical information and results of neuroimaging, were included in our study. Demographic characteristics, clinical features, types of visual field defects, location of lesion and evolution of visual field defects were recorded.
RESULTS
Of the 880 patients with homonymous hemianopia seen in our unit, 103 patients (112 with homonymous hemianopia) had TBI (74 men and 29 women, mean age 30.7 (SD 15.3) years). Median time from injury to initial visual field testing was 5 (range 0.5-360) months. In all, 64 (57.1%) patients sustained injuries that were motor vehicle-related; 19 (17%) violence-related; 17 (15.2%) due to falls; and 12 (10.7%) because of other blunt head trauma. Visual field defects included complete homonymous hemianopia in 44 (39.3%) patients and incomplete homonymous hemianopia in 68 (60.7%) patients. The lesion was occipital in 14 (12.5%) patients, associated with optic radiation in 26 (23.2%) and the optic tract in 12 (10.7%), and multiple in 60 (53.6%).
CONCLUSION
Most cases of homonymous hemianopia from TBI were motor vehicle-related. Patients were younger, more often male, and had multiple brain lesions more often than patients with homonymous hemianopia from causes other than TBI. A median delay of 5 months was observed before the documentation of the homonymous hemianopia, which may have a major effect on the success of rehabilitation and driving training in these young patients.
Topics: Accidents, Traffic; Adolescent; Adult; Aged; Brain Injuries; Child; Child, Preschool; Female; Hemianopsia; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Sex Factors
PubMed: 16574725
DOI: 10.1136/jnnp.2006.088799 -
Frontiers in Neurology 2022Spinal neurofibromatosis (SNF) is a rare form of Neurofibromatosis in which neurofibromas exist bilaterally throughout all spinal roots. Despite previous attempts made...
Spinal neurofibromatosis (SNF) is a rare form of Neurofibromatosis in which neurofibromas exist bilaterally throughout all spinal roots. Despite previous attempts made to characterize and classify the disease as a separate clinical form of the disease, the low incidence rate of the disease and scarcity of previous reports calls for further studies and reports to elaborate this clinical entity. The patient in this report was a 36-year-old man presenting with lower limb weakness, unsteady gait, and paresthesia. The patient also presented with multiple cutaneous café-au-lait spots, cutaneous neurofibromas, and a large neurocutaneous neurofibroma of right facial nerve. Magnetic resonance imaging (MRI) of spine revealed bilateral spinal neurofibromas across all spinal cord roots. MRI study of head revealed no abnormalities in the brain and optic tract. The patient fulfilled both NIH criteria as well as revised criteria for NF1. Despite total spinal cord involvement, surgical intervention was withheld from the patient due to high propensity of recurrence as seen with previous attempts in removing peripheral neurofibromas, slow progression of symptoms, and lack of significant pain and impairment. SNF is often described as a form of disease with infrequent presentation of classical NF1 symptoms other than spinal tumors. The case presented here however, presented with several cutaneous neurofibromas and café-au-lait spots. Considering the positive outcome of surgical intervention in a few other reports, the decision to surgically intervene should be left to the clinical judgement of the participating surgeon, patient preference and socioeconomic background in a case-by-case manner.
PubMed: 36034297
DOI: 10.3389/fneur.2022.976929 -
Brain Research Reviews Jan 2011Many of the axons that carry messages to the thalamus for relay to the cerebral cortex are branched in a pattern long known from Golgi preparations. They send one branch... (Review)
Review
Many of the axons that carry messages to the thalamus for relay to the cerebral cortex are branched in a pattern long known from Golgi preparations. They send one branch to the thalamus and the other to motor centers of the brainstem or spinal cord. Because the thalamic branches necessarily carry copies of the motor instructions their messages have the properties of efference copies. That is, they can be regarded as providing reliable information about impending instructions contributing to movements that will produce changes in inputs to receptors, thus allowing neural centers to compensate for these changes of input. We consider how a sensory pathway like the medial lemniscus, the spinothalamic tract or the optic tract can also be seen to act as a pathway for an efference copy. The direct connections that ascending and cortical inputs to the thalamus also establish to motor outputs create sensorimotor relationships that provide cortex with a model of activity in lower circuits and link the sensory and the motor sides of behavior more tightly than can be expected from motor outputs with a single, central origin. These transthalamic connectional patterns differ from classical models of separate neural pathways for carrying efference copies of actions generated at higher levels, and introduce some different functional possibilities.
Topics: Afferent Pathways; Animals; Axons; Cerebral Cortex; Feedback, Physiological; Humans; Thalamus
PubMed: 20696186
DOI: 10.1016/j.brainresrev.2010.08.001 -
Cureus Mar 2022Mucormycosis is a life-threatening invasive fungal infection usually seen in immunocompromised patients and patients with poorly controlled diabetes mellitus with or...
Mucormycosis is a life-threatening invasive fungal infection usually seen in immunocompromised patients and patients with poorly controlled diabetes mellitus with or without diabetic ketoacidosis. We present a rhino-orbito-cerebral mucormycosis (ROCM) case in a coronavirus disease 2019 (COVID-19) patient complicated by the optic nerve and optic tract ischemia with ischemic neuropathy. Both CT and MRI played an essential role in diagnosing ROCM and the accompanying complications in our patient. CT showed sinonasal sinusitis and MRI showed the sinusitis and its progression to ROCM. MRI also showed necrosis involving the bilateral orbits, basal ganglia, thalamus, internal capsule, hypothalamus, optic chiasm, optic nerves, olfactory bulbs, and skull base. ROCM associated with optic nerve ischemia is a rare but life-threatening complication of COVID-19, especially in patients with underlying diabetes and/or those treated with corticosteroids. Physicians should be aware of this complication as early diagnosis may improve the chances of survival in such patients.
PubMed: 35464546
DOI: 10.7759/cureus.23068 -
International Journal of Molecular... Apr 2021Glaucoma is a multifactorial disease that is conventionally managed with treatments to lower intraocular pressure (IOP). Despite these efforts, many patients continue to... (Review)
Review
Glaucoma is a multifactorial disease that is conventionally managed with treatments to lower intraocular pressure (IOP). Despite these efforts, many patients continue to lose their vision. The degeneration of retinal ganglion cells (RGCs) and their axons in the optic tract that characterizes glaucoma is similar to neurodegeneration in other age-related disorders of the central nervous system (CNS). Identifying the different molecular signaling pathways that contribute to early neuronal dysfunction can be utilized for neuroprotective strategies that prevent degeneration. The discovery of insulin and its receptor in the CNS and retina led to exploration of the role of insulin signaling in the CNS. Historically, insulin was considered a peripherally secreted hormone that regulated glucose homeostasis, with no obvious roles in the CNS. However, a growing number of pre-clinical and clinical studies have demonstrated the potential of modulating insulin signaling in the treatment of neurodegenerative diseases. This review will highlight the role that insulin signaling plays in RGC neurodegeneration. We will focus on how this pathway can be therapeutically targeted to promote RGC axon survival and preserve vision.
Topics: Animals; Disease Models, Animal; Glaucoma; Humans; Insulin; Molecular Targeted Therapy; Neurodegenerative Diseases; Neuroprotection; Retina; Retinal Ganglion Cells; Signal Transduction
PubMed: 33925119
DOI: 10.3390/ijms22094672 -
Cells & Development Jun 2021Slit-Robo signaling has been implicated in regulating several steps of retinal ganglion cell axon guidance, with a central role assigned to Slit2. We report here the...
Slit-Robo signaling has been implicated in regulating several steps of retinal ganglion cell axon guidance, with a central role assigned to Slit2. We report here the phenotypical characterization of a CRISPR-Cas9-generated zebrafish null mutant for this gene, along with a detailed analysis of its expression pattern by WM-FISH. All evident defects in the optic axons in slit2-/- mutants were detected outside the retina, coincident with the major sites of expression at the ventral forebrain, around the developing optic nerve and anterior to the optic chiasm/proximal tract. Anterograde axon tracing experiments in zygotic and maternal-zygotic mutants, as well as morphants, showed the occurrence of axon sorting defects, which appeared mild at the optic nerve level, but more severe in the optic chiasm and the proximal tract. A remarkable sorting defect was the usual splitting of one of the optic nerves in two branches that surrounded the contralateral nerve at the chiasm. Although all axons eventually crossed the midline, the retinotopic order appeared lost at the proximal optic tract, to eventually correct distally. Time-lapse analysis demonstrated the sporadic occurrence of axon misrouting at the chiasm level, which could be responsible for the sorting errors. Our results support previous evidence of a channeling role for Slit molecules in retinal ganglion cell axons at the optic nerve, in addition to a function in the segregation of axons coming from each nerve and from different retinal regions at the medio-ventral area of the forebrain.
Topics: Amino Acid Sequence; Animals; Axons; Base Sequence; Cell Differentiation; Gene Expression Regulation, Developmental; Intracellular Signaling Peptides and Proteins; Models, Biological; Mutation; Optic Chiasm; Optic Nerve; Retinal Ganglion Cells; Visual Pathways; Zebrafish; Zebrafish Proteins
PubMed: 33994352
DOI: 10.1016/j.cdev.2021.203677 -
Revista Brasileira de Ginecologia E... May 2023Pituitary apoplexy refers to a rare clinical syndrome consisting of signs and symptoms that occur due to rapid expansion of the contents of the . It can occur... (Review)
Review
Pituitary apoplexy refers to a rare clinical syndrome consisting of signs and symptoms that occur due to rapid expansion of the contents of the . It can occur spontaneously or associated with pituitary tumors. It can have a broad clinical spectrum, but usually presents with severe headache, visual impairment and hypopituitarism. Sudden onset of symptoms associated to imagiologic confirmation makes the diagnosis. Surgical treatment is advised when there is important compression of the optic tract. We present a case report and a review of the literature on pituitary apoplexy in pregnancy. The cases were reviewed to obtain information on maternal characteristics, clinical presentation, diagnostic studies, therapeutic modalities and maternal and fetal outcomes. Our review found 36 cases of pituitary apoplexy in pregnancy. Most of the cases occurred in the second trimester of pregnancy and headache was the most frequent symptom at presentation. Surgical therapy was required in more than half of the patients. In what respect maternal and fetal outcomes, there were 3 cases of preterm delivery and one case of maternal death. Our clinical case and literature review reinforces the importance of an early diagnosis to avoid potential adverse consequences.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Pituitary Apoplexy; Pituitary Neoplasms; Prenatal Care; Maternal Death; Headache
PubMed: 37339647
DOI: 10.1055/s-0043-1770128 -
Oncology Letters Nov 2015The current study reports the case of a 68-year-old, previously healthy female who presented with progressive visual impairment leading to blindness bilaterally. Brain...
The current study reports the case of a 68-year-old, previously healthy female who presented with progressive visual impairment leading to blindness bilaterally. Brain imaging features were suggestive of malignant glioma of the anterior visual pathway. Postoperative examination indicated a diagnosis of diffuse malignant lymphoma type B. As no evidence of extracranial lymphoma was observed, the final diagnosis was primary central nervous system lymphoma (PCNSL). Following treatment with surgery and radiotherapy, the patient's symptoms went into remission. At a follow-up examination 12 months after diagnosis, the patient demonstrated no evidence of recurrence. To the best of our knowledge, PCNSL isolated to the optic chiasm has been reported only three times in immunocompetent patients. Therefore, the present case of the lymphoma involving the optic nerve, optic chiasm and optic tract in an immunocompetent patient is unusual. The present case emphasizes the importance of considering the diagnosis of lymphoma in this setting.
PubMed: 26722281
DOI: 10.3892/ol.2015.3675 -
Ocular Oncology and Pathology Nov 2018Optic nerve haemangioblastomas remain exceedingly rare extrinsic tumours of the optic nerve, often associated with von Hippel-Lindau disease. The authors report a...
Optic nerve haemangioblastomas remain exceedingly rare extrinsic tumours of the optic nerve, often associated with von Hippel-Lindau disease. The authors report a 25-year-old female with a slowly progressive unilateral optic nerve lesion, causing reduced vision and bilateral optic tract oedema. A diagnosis of optic nerve haemangioblastoma with piloid gliosis was made histologically after surgical resection. This is the first reported case of such dual pathology occurring in the optic nerve. The patient has been monitored without further adjuvant treatment, and has not had a recurrence to date, at 6 years of follow-up.
PubMed: 30574489
DOI: 10.1159/000486863