Biomedical subjects

B R Younge

Publications and source records attributed to B R Younge.

50 records · Page 3Linked to original sources

PubMed1980

Evaluation of the causes and accuracy of pharmacologic localization in Horner's syndrome.

Of 450 cases of Horner's syndrome examined by pupillography. 13% were caused by tumor but less than 3% were undetected malignant tumors. The largest group of lesions (40%) had an undetermined cause, presumably related to vascular disease. Although the hydroxyamphetamine test usually can differentiate postganglionic from preganglionic lesions, its clinical value and accuracy for this purpose has been overemphasized in previous reports. Of the 13 undetected malignant neoplasms, nine (69%) manifested as Pancoast's syndrome with arm pain, a reliable sign to identify patients with Horner's syndrome caused by undetected malignancy.

Adolescent↗

PubMed1980

Computer-assisted perimetry in neuro-ophthalmic disease.

A computer-assisted perimeter has become available commercially and has been evaluated and compared with standard kinetic field testing in patients with neuro-ophthalmic disease. Threshold testing by static means has provided evidence of field defects at a stage usually too subtle to record by standard methods. The machine is quite well standardized and controlled and has had only a few technical problems. Newer programs can be added by means of a change in floppy disk, and this capability promises additional avenues of clinical investigation.

Adult↗

PubMed1980

Resolution of venous stasis retinopathy after carotid artery bypass surgery.

Venous stasis retinopathy associated with carotid occlusive disease has been found to diminish or even disappear after carotid artery bypass surgery (superficial temporal artery to middle cerebral artery anastomosis). We present photographic documentation of these changes and subsequent resolution of the retinopathy in a patient who had bypass surgery. This resolution reflects the increased perfusion to the retina and to the cerebral hemisphere.

Arterial Occlusive Diseases↗

PubMed1978

Treatment of acute central retinal artery occlusion.

Central retinal artery occlusion very often leads to irreversible visual loss and seldom responds to treatment. Retrograde cannulation of the supraorbital artery followed by irrigation with anticoagulants and vasodilators may be of value in the early management of this problem. A case in point is described.

Adult↗

PubMed1977

Analysis of trochlear nerve palsies. Diagnosis, etiology, and treatment.

At the McGill University neuro-ophthalmology unit, 52 patients with superior oblique palsy were seen during the 2-year period October 1973 to August 1975; these included patients with congenital, traumatic, vascular, and other more rare causes of trochlear paralysis. Half of the patients with congenital palsy had diplopia, requiring treatment, although surgery was rarely necessary. Patients with palsy due to trauma, the major cause in our series, included four with bilateral involvement. With the exception of recovery in a single muscle of one patient in this group with traumatic palsy, no spontaneous recoveries have been observed. Treatment modalities have been tried, including observation alone, occlusion for symptomatic relief of diplopia, use of prisms, and recession of the ipsilateral inferior oblique muscle. Four patients with palsy of presumed vascular cause recovered spontaneously within a 4-month period. All patients who were surgically treated improved.

Adolescent↗

PubMed1976

Fluorescein angiography and retinal venous sheathing in multiple sclerosis.

Venous sheathing found in 11% of a series of patients with multiple sclerosis was studied with routine color fundus photography, and fluorescein angiography. In the early phases of the disease, sheathing is seldom found. Its detection is facilitated by fluorescein angiography and ophthalmoscopy with a cobalt filter. Fluorescein leakage may disappear despite persistence of the sheathing.

Adult↗

PubMed1976

Electronystagmographic findings in cerebellar dysfunction.

Ocular dysmetria is seldom mentioned in the neurootologic literature as an electronystagmographic (ENG) abnormality. For the last two years, we found ocular dysmetria on 38 cases out of 1,879 ENG recordings. Cerebellar dysfunction was the most apparent cause in 13 out of 21 cases examined by us. The group of unilateral hypermetria showed some other ENG abnormalities like positional nystagmus, post-caloric directional preponderance, failure of fixation suppression of post-caloric nystagmus (FFS), more scattered distribution of quick phase amplitudes of post-caloric and optokinetic nystagmus on the side of hypermetria. We wonder whether this symptomatology, or at least part of it, is due to dysfunction of the flocculo-nodular lobe of the cerrebellum.

Aged↗

PubMed1976

Midline tilting between seeing and nonseeing areas in hemianopia.

The line separating the seeing from the nonseeing parts of the visual field was found to be tilted away from the expected vertical position in 24 of 200 patients diagnosed as having various types of hemianopia, including homonymous hemianopia, homonymous quadrant hemianopia, homonymous scotomata, and bitemporal hemianopia. The causes of these defects include vascular accidents, trauma, tumor, and neurosurgery for convulsive disorders. Once discovered by standard monocular field testing methods, the existence of the tilting phenomenon was distinguished from testing artifact by employing binocular fixation and red-green glasses along with red and green test objects. A difference in the overlapping fields of the two eyes was found to exist only in areas where corresponding lines between seeing and nonseeing fields were separated by a tilting away from the vertical in one or both eyes. This can occur superiorly or inferiorly with homonymous scotomata, and in bitemporal hemianopia as well as in homonymous hemianopia or quadrant hemianopia. This incongruity of fields is possibly explained by a variation in anatomic determination of crossing from noncrossing fibers at the level of the retina.

Adult↗

PubMed1976

Tonic pupil: a simple screening test.

The tonic pupil has a typical appearance and characteristic reactions to both light and the near reflex. Testing with Mecholyl (methacholine) is not possible since the drug is no longer manufactured. The reactions of a group of 25 patients with tonic pupil were studied using dilute pilocarpine, and compared with the pupil responses of a separate control group. We found that concentrations of 0.2% pilocarpine produced too many false-positive reactions in the control group and that 0.05% pilocarpine produced an insufficient response. The 0.1% concentration seemed suitable for ordinary clinical examinations and is recommended for pharmacologic confirmation of the diagnosis of tonic (Adie's) pupil.

Adie Syndrome↗

PubMedDate not supplied

Intracranial plasma cell granuloma presenting as an optic neuropathy.

A 40-year-old man presented with a left optic neuropathy. Magnetic resonance imaging demonstrated a contrast-enhancing mass along the course of the left trigeminal nerve and in the region of the left cavernous sinus with suprasellar extension. Preoperatively, he had a serum polyclonal gammopathy. Pathologic diagnosis was an intracranial plasma cell granuloma. The patient responded to high-dose steroids with resolution of his optic neuropathy, marked decrease in the size of the mass, and resolution of the serum polyclonal gammopathy. Intracranial plasma cell granuloma is a rare lesion; only 11 cases have been described in the literature. Almost half of the patients presented with vision loss as their chief complaint.

Adult↗

PubMedDate not supplied

Ophthalmic manifestations of lightning strike.

Every year in the USA, 100-150 people die and 1000-1500 others are injured by lightning strikes. Ophthalmic and neurologic injuries from lightning strike are common. The most common permanent ocular sequela is cataract, but many areas of the eye can be affected. Prompt evaluation by an ophthalmologist is imperative for maximizing outcomes. Incidence and mechanisms of lightning strike injury are summarized, with special emphasis on the treatment of ocular injuries.

Cataract↗

PubMedDate not supplied

Ocular pneumoplethysmography and ophthalmodynamometry in the diagnosis of central retinal artery occlusion.

Ocular pneumoplethysmography and ophthalmodynamometry measure ophthalmic arterial system pressures to assess noninvasively the hemodynamics of the carotid system. A previously unreported circumstance in which these tests complement one another is central retinal artery occlusion. Typically, the ipsilateral retinal artery pressure, measured by ophthalmodynamometry, is greatly decreased or is zero, whereas the ophthalmic systolic pressure, measured by ocular pneumoplethysmography, is normal.

Aged↗

PubMedDate not supplied

Atypical amiodarone-induced keratopathy in a patient wearing soft contact lenses.

Antiarrhythmic therapy with amiodarone hydrochloride may produce a pattern of vortex corneal epitheliopathy or cornea verticillata. The vortex keratopathy typically occupies the lower third of the cornea, extends superiorly, and is graded according to the degree of extension. Grades I through III describe the amount of vortex change, whereas grade IV describes a generalized granular dusting in addition to the vortex pattern. Grade IV amiodarone-induced keratopathy has been reported from Europe, but no North American series have reported this more advanced epithelial change. We describe a patient who developed grade IV amiodarone-induced keratopathy while wearing soft contact lenses. Of 686 patients treated with amiodarone at the Mayo Clinic and undergoing routine follow-up, this is the first case of grade IV keratopathy we have observed. To our knowledge, this is also the first report of a patient who wore contact lenses and developed this uncommon corneal change while taking amiodarone.

Aged↗

PubMedDate not supplied

Radiologic evaluation of tumors of the optic nerve.

The case material of 42 patients with primary tumors of the optic nerve and chiasm examined at our institution within a 10 year period was reviewed. In each case, the radiologic data and certain clinical information were compiled to determine the role of radiology in the workup of patients with these tumors and to compare the results of various imaging methods. Although different types of information are obtained from each method, late-generation computed tomography provides the most useful and complete information about optic nerve gliomas and intraorbital optic nerve meningiomas. Angiography is also helpful in the evaluation of intracranial optic nerve meningiomas.

Adolescent↗