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2.1
Pulsating Exophthalmos
Exophthalmos Pulsating

Presentation

Other patients presented demonstrate the strong familial trend of neurofibromatosis, the multiplicity of lesions, the progression of lesions. [ncbi.nlm.nih.gov]

Presentation : these variably present from early childhood (especially lymphangiomas) to adulthood. Varices present with intermittent proptosis (evident in the Valsalva manoeuvre) ± visible lesions in the eyelid. [patient.info]

Three patients in our study presenting with proptosis were proved to be metastases in the orbit. [ijri.org]

Skin

  • Subcutaneous Nodule

    He had facial asymmetry, multiple cutaneous café-au-lait spots and a subcutaneous nodule, biopsy of which showed features consistent with neurofibromatosis. [ncbi.nlm.nih.gov]

Eyes

  • Unilateral Proptosis

    CLASSIFICATION Proptosis can be divided into following clinical groups: Unilateral proptosis Bilateral proptosis Acute proptosis Intermittent proptosis Pulsating proptosis ETIOLOGY Important causes of proptosis in each clinical group are listed here: [ikeyes.blogspot.com]

  • Conjunctival Injection

    Red eye - conjunctival injection increases with the exophthalmos. In severe cases, there may be a secondary exposure keratopathy as a result of incomplete lid closure over the cornea. [patient.info]

Neurologic

  • Papilledema

    Dilated fundus exam: OD—normal fundus; OS—grade 3 papilledema with palor (see Figure 3) Figure 1 : Multiple café au lait spots Figure 2 : Axial pigmentation and freckling was apparent on exam Figure 3 : Papilledema and palor of the optic disc are observed [webeye.ophth.uiowa.edu]

    Dural arteriovenous malformations and papilledema. Neurosurgery 1988; 22 : 1079–1084. [nature.com]

    Common signs of CCF include proptosis, temporal/orbital bruit, chemosis, extraocular palsy, pulsating exophthalmos, elevated IOP, anterior segment ischemia, papilledema, optic nerve atrophy and trigeminal nerve involvement. [healio.com]

Workup

The phase of the disease will then ultimately determine the indicated workup and treatment. Differential Diagnosis Depending on the presenting symptoms, further workup can be necessary to rule out other possible diagnoses. [reviewofophthalmology.com]

Treatment

[…] sinus fistulas and their treatment with balloon catheters 205 Closure of carotidcavernous fistulas by intracavernous surgical insertion of biological materials 211 Carotid cavernous aneurysms and fistulas 225 [books.google.com]

L. : Specific treatment of intracranial aneurysms. Experiences with 143 surgically treated patients. J. Neurosurg. 8 ( 1951 ), 75. Google Scholar | Medline [journals.sagepub.com]

The diagnosis and treatment of thyroid-associated ophthalmopathy. Aesth Plast Surg 2012;36:638-648. 11. Stan MN, Garrity JA, Bahn RS. The evaluation and treatment of Graves’ ophthalmopathy. Med Clin N Am 2012;96:311-328. 12. [reviewofophthalmology.com]

Treatment is via surgical excision. [patient.info]

Prognosis

Late facial paralysis is usually a better prognosis than the paralysis that occur immediately. FRACTURES stones can cause bone and VIII cranial nerve injury, resulting in hearing loss, vertigo and nystagmus immediately after the injury. [medicaldb.blogspot.com]

Visual prognosis in carotid-cavernous fistula. Arch Ophthalmol. 1981;99(9):1600-1603. [healio.com]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]

Otorhinolaryngological examination is necessary when the paranasal sinus or a nasopharyngeal mass apears to be a possible etiological factor. II. [ikeyes.blogspot.com]

A etiologic factors include trauma, surgery, infection, and sinus thrombosis. 3, 4, 5 The clinical presentations of DAVMs depend on the location of the DAVM and include tinnitus, cranial nerve palsies, and/or signs related to venous congestion in the [nature.com]

Proptosis, chemosis, episcleral venous congestion Given that trauma is the etiology of the patient’s signs and symptoms, the differential diagnosis becomes quite narrow. [healio.com]

Epidemiology

Epidemiology and prevention of Graves' ophthalmopathy. Thyroid. 2002 Oct. 12(10):855-60. [Medline]. Putta-Manohar S, Perros P. Epidemiology of Graves' orbitopathy. Pediatr Endocrinol Rev. 2010 Mar. 7 Suppl 2:182-5. [Medline]. [emedicine.medscape.com]

The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 1994;92:477-588. 4. Stan MN, Bahn RS. [reviewofophthalmology.com]

Diagnosis: Optic nerve glioma associated with Neurofibromatosis Type 1 EPIDEMIOLOGY of NF1 Rare condition (1 per 3-4,000 people) characterized by hamartomas of neural crest origin Autosomal dominant inheritance Variable expressivity, 100% penetrance Half [webeye.ophth.uiowa.edu]

Pathophysiology

Decreased vision - visual acuity may be impaired by: Direct optic nerve involvement due to the pathophysiology. Distortion of the macula by a lesion pushing in behind the globe. Exposure keratopathy (see above) can also affect the visual acuity. [patient.info]

The pathophysiology of thyroid eye disease: implications for immunotherapy. Curr Opin Ophthalmol. 2011 Sep. 22 (5):385-90. [Medline]. Ugradar S, Rootman DB. Case Series: Noninflammatory Thyroid Eye Disease. [emedicine.medscape.com]

Prevention

Hip Fracture Prevention in Older Adults in 2019 This JAMA Insights Clinical Update reviews approaches to fracture prevention in older adults, including estimating fracture risk and life expectancy, selecting and managing appropriate medications, an... [bioportfolio.com]

Early detection and treatment could prevent vision loss. See an eye care professional right away if you have a sudden change in vision, if everything looks dim, or if you see flashes of light. [icdlist.com]

In hypothermic patients, I found cardiac arrhythmias could be induced by manipulation of vessels of the Circle of Trellis as well as by other stimuli and could be prevented or alleviated by IV sodium pentathal JNS, 1958). Microsurgery. [neurosurgery.org]

Prevent and plan for complications in advance by examining over 1,600 illustrations, photos and graphics (1,250 in color) capturing essential diagnostics techniques, imaging methods and surgical approaches. [books.google.com]

Despite the benefits, the side-effect profile of corticosteroids prevents their long-term use. [reviewofophthalmology.com]

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