Biomedical subjects
Publications and source records attributed to J W Gittinger.
A 31-year-old woman presented with signs and symptoms of anterior and posterior cerebral circulatory insufficiency. The differential diagnosis and therapeutic options are discussed. The most likely cause is a cardiogenic source of emboli.
A nine-and-one-half month old boy with poor visual function was found to have bilaterally small optic discs. He subsequently demonstrated a retarded growth pattern. A series of photographs revealing part of the spectrum of optic disc hypoplasia are included. Associated structural and endocrine defects as well as various opinions concerning the appropriate approach to these patients are discussed.
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A 28-year-old woman presented with a history of unilateral throbbing headache associated intermittently with transient pupillary dilation. The differential diagnosis and suggested method of investigation are discussed. Therapeutic recommendations are mentioned for the treatment of common migraine.
A 68-year-old woman experienced rapid progressive visual loss to blindness over a seven-week period. Inadequate clinical and diagnostic testing masked the diagnosis of a malignant glioma of adulthood.
A 39-year-old woman presented to her ophthalmologist complaining of floaters. This was associated with elevation of the optic disc and late staining of the retinal veins. The differential diagnosis of venous occlusive disease is discussed.
A 76-year-old woman presents with the classic findings of a carotid-cavernous fistula, including a red eye due to arterialization of the conjunctival veins, proptosis, retinal venous obstructive disease and elevated intraocular pressure. Enlarged extraocular muscles were found on CT scan leading to the misdiagnosis of thyroid orbitopathy. The differential diagnosis and therapy of the dural cavernous fistula and the intraocular pressure are discussed.
The controversial history of functional hemianopsia is reviewed from Briquet's 1859 monograph on 430 cases of hysteria, through the 19th century works of Charcot, Freud, and Janet, and the observations of Fox and Wilbrand and Saenger in the early 20th century. More recently, concepts of this entity have been clarified by modern binocular testing of visual fields.
A 70-year-old man presented with mild retrobulbar discomfort and diplopia with a marked left abduction deficit. Three days later the patient noted a sudden decrease of vision in his left eye. A CT scan revealed enhancement of structures of the left orbital apex. A discussion of the differential diagnosis, appropriate testing procedures, and suggested treatment is included. The patient responded to corticosteroid therapy with complete resolution of the problem.
An 8-year-old girl was first seen at the age of 4 with nystagmus and hypoplastic discs. Subsequent follow-up demonstrated poor visual acuity and optic atrophy. A CT scan showed a chiasmal or perichiasmal mass. The presumptive diagnosis of an optic chiasmal glioma is being considered. The use of neuroimaging in chiasmal or perichiasmal lesions and the natural history and treatment of optic nerve and chiasmal gliomas are discussed.
The professional life of David G. Cogan was characterized by both personal accomplishments and the nurture of his students and colleagues.