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Biomedical subjects

J R Keane

Publications and source records attributed to J R Keane.

At least 73 records · Page 4Linked to original sources
PubMed1984

Levator-sparing oculomotor nerve palsy caused by a solitary midbrain metastasis.

One month before death, a 63-year-old man with known lung carcinoma manifested a left third-nerve palsy and crossed ataxia. The oculomotor involvement began with a dilated left pupil and progressed to a complete left oculomotor nerve palsy, with the exception of nearly normal lid function. Pathologic examination revealed a solitary midbrain metastasis involving the left third-nerve nucleus and rootlets, with the exception of the caudal central oculomotor subnucleus and its outflow fibers.

Adenocarcinoma↗
PubMed1984

Galloping tongue: post-traumatic, episodic, rhythmic movements.

Two patients experienced delayed onset of episodic, rhythmic, involuntary movements of the tongue after head and neck trauma. These three-per-second waves began as posterior midline focal tongue contractions, lasted about 10 seconds in each episode, persisted for 2 to 4 months, and were not accompanied by other body movements or by EEG abnormality.

Adult↗
PubMed1984

Pituitary apoplexy presenting with epistaxis.

A 42-year-old woman developed headache and epistaxis followed by fever, stiff neck, and loss of vision of the right eye. The diagnosis of simple epistaxis was changed to mucormycosis, then to bacterial meningitis and then to sphenoid sinusitis, before the correct diagnosis of pituitary apoplexy was established by CT scan. Epistaxis is yet another confusing symptom of pituitary apoplexy.

Adenoma↗
PubMed1983

Abnormal visual evoked potentials in myotonic dystrophy.

Pattern-shift visual evoked potentials (VEPs) were recorded in 17 patients with myotonic dystrophy. Abnormalities of latency or amplitude were found in 10 patients (59%) with no obvious retinal or other significant ocular abnormality. All patients had a visual acuity of 20/30 or better. Since most patients had bilateral VEP abnormalities, localization of the disturbance was not certain.

Adult↗
PubMed1982

Neuro-ophthalmologic signs and symptoms of cysticercosis.

Fifty-six patients with cysticercosis and neuro-ophthalmic signs were examined by me during an 11-year period. Their symptoms generally reflected increased intracranial pressure caused by hydrocephalus, subacute meningitis, cerebral masses or a combination of these effects. Papilledema (37 patients) was the commonest sign, with pupillary abnormalities (16 patients) and nystagmus (12 patients) frequently encountered. Cysticercosis is a relatively benign, although episodic, disease, as long as secondary obstructive hydrocephalus is promptly diagnosed and treated by CSF shunting procedures.

Adolescent↗
PubMed1981

Papilledema with unusual ocular hemorrhages.

Fourteen patients with posterior pole retinal hemorrhages or prominent subhyaloid and vitreous bleeding were found during examination of 402 consecutive patients with papilledema (4%). Subhyaloid and vitreous hemorrhage generally result from forward dissection of severe peripapillary hemorrhage, whereas scattered posterior pole hemorrhages probably represent central retinal vein compromise from optic disc swelling. The bilaterality and severity of papilledema, as well as the clinical course, distinguish these patients from those with venous hemorrhages in association with subarachnoid bleeding or primary central retinal vein occlusion or inflammation.

Adult↗
PubMed1981

Sustained upgaze in coma.

Coma with sustained upward gaze deviation followed cardiac arrest in 15 patients and prolonged systemic hypotension in 2 patients. Neuropathological examinations confirmed the expected diffuse cerebral and cerebellar damage with relative sparing of the brainstem. No focal lesions were found in the upper midbrain or pretectum. Six patients developed slow, downward-beating nystagmus as the forced upward gaze resolved. Four of 6 patients with posthypoxic facial myoclonic jerks demonstrated synchronous upward gaze movements. Forced upgaze in come usually is the result of severe hypoxic encephalopathy. While anatomical localization is obscure, this sign does not indicate a structural lesion in the pretectum or midbrain and may result from damage to cerebellar pathways.

Adult↗
PubMed1980

Transient opsoclonus with thalamic hemorrhage.

Opsoclonus, a rare and dramatic saccadic eye movement disorder, was seen in three patients following thalamic hemorrhage. The occurrence of this presumed cerebellar-system disorder in association with pupillary and oculomotor signs of pretectal dysfunction suggests that upper brainstem damage may facilitate the release of spontaneous saccades.

Aged↗
PubMed1980

Blindness following tentorial herniation.

In seven patients, permanent bilateral visual loss was the chief neurological residual following relief of tentorial herniation. The causes of herniation were unilateral subdural hematoma in three patients and bilateral subdural hematomas, bilateral subdural empyemas, traumatic intracerebral hematoma, and postoperative infarction in one patient each. Three patients, including two with occipital infarction documented by computed tomographic scan, developed optic atrophy, indicating that both pregeniculture visual pathway damage and posterior cerebral artery compression occurred. Increasing availability of computed tomographic scanning should help eliminate this rare cause of blindness by facilitating earlier diagnosis of supratentorial masses.

Adolescent↗