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Biomedical subjects

M P Kolsky

Publications and source records attributed to M P Kolsky.

12 recordsLinked to original sources
PubMed1996

Unilateral optic neuritis caused by Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome.

PURPOSE: To evaluate the potential of Histoplasma capsulatum to cause optic neuritis in the setting of the acquired immunodeficiency syndrome (AIDS). METHODS: We examined a 35-year-old man with a history of AIDS and disseminated histoplasmosis who developed a unilateral progressive optic neuritis of enigmatic origin. An optic nerve sheath biopsy was performed to provide a tissue diagnosis. RESULTS: Histoplasma capsulatum was identified in both the optic nerve sheath and fungal culture. CONCLUSION: Histoplasma capsulatum should be considered in the differential diagnosis of optic neuritis in patients with AIDS, even in the absence of chorioretinal findings.

AIDS-Related Opportunistic Infections↗
PubMed1994

Anterior ischemic optic neuropathy in Churg-Strauss syndrome.

A patient with a history of chronic rhinitis, sinusitis, and bronchial asthma developed a unilateral anterior ischemic optic neuropathy and a mild sensory motor neuropathy as the initial manifestation of systemic vasculitis. We made a probable diagnosis of Churg-Strauss syndrome. Fluorescein angiography showed delayed choroidal perfusion in both eyes. Marked eosinophilia, increased sedimentation rate, and elevated perinuclear anti-neutrophil cytoplasmic antibody and anti-myeloperoxidase antibody titers were the main laboratory abnormalities that supported this diagnosis. Therapy with high-dose methylprednisolone and cyclophosphamide may have preserved vision in the better seeing eye, improved its choroidal circulation, and reversed the laboratory abnormalities except for a mild persistent eosinophilia. The neuropathy is gradually improving.

Administration, Oral↗
PubMed1992

Traumatic lesions of the suprasellar region: MR imaging.

The authors studied nine patients with injuries to the suprasellar region with 1.5-T magnetic resonance (MR) imaging. Five patients had chiasmal injuries diagnosed by means of clinical examination. MR imaging demonstrated complete transection in two of these five patients, contusion of the chiasm by inferior herniation of the gyrus rectus in one, and a normal chiasm in two. Two patients had large tears of the floor of the third ventricle resulting in wide communication between the third ventricle and the prepontine cistern. One of these patients also had an avulsed third nerve. Transection of the pituitary stalk was seen in two patients. MR imaging can demonstrate injuries to the suprasellar structures. The MR imaging appearance of optic chiasm correlates with different types of injury to the chiasm described in the clinical literature and may alleviate the need for additional diagnostic studies to help explain the patient's symptoms.

Adult↗
PubMed1991

Hemianopsia from occipital lobe abscess after dental care.

We treated four patients who developed a homonymous hemianopsia from a bacterial abscess in the occipital lobe of the brain. All four patients were treated successfully by surgical drainage of the abscess and administration of parenteral antibiotics for at least six weeks. Despite cure of the brain abscess, each patient was left with a permanent residual homonymous visual field defect. Cultures from the abscess fluid in three of the four patients grew oral flora. Moreover, each patient had a history of dental care two to four weeks before the onset of visual symptoms. A history of recent dental treatment in a patient with a new hemianoptic field defect should alert the ophthalmologist to the possibility of a bacterial abscess in the occipital lobe.

Adolescent↗
PubMed1990

Bilateral orbital involvement in fatal giant cell polymyositis.

The case of a young woman with giant cell polymyositis is described. She had bilateral, severe, midly painful proptosis and ophthalmoplegia. Extensive pharyngeal, laryngeal, and cardiac muscle involvement occurred 18 months later coincident with fatal cardiac arrhythmia. At autopsy, extensive muscle necrosis and giant cells were noted in extraocular, pharyngeal, laryngeal, and cardiac muscle with only minimal involvement of other striated muscles.

Adult↗
PubMed1984

Positional vertigo and the cerebellar vermis.

A patient with lower and posterior vermis hematoma presented with truncal ataxia; paroxysmal, positional, downbeating nystagmus; and saccade dysmetria. Drainage of the hematoma resulted in complete resolution of all signs and symptoms.

Adult↗
PubMed1983

Primary position vertical nystagmus and cerebellar ataxia.

Hereditary cerebellar ataxia was evaluated clinically and by electro-oculography in three members of a family. There was no clinical evidence of exttra-cerebellar dysfunction although quantitative eye movement analysis did shown internuclear ophthalmoparesis and slow saccadic velocity suggestive of brainstem dysfunction. In addition, oculomotor examination showed primary position vertical nystagmus in all patients. Other findings were in accord with previous reports of cerebellar-related oculomotor dysfunction.

Adolescent↗
PubMedDate not supplied

Common errors in the use of magnetic resonance imaging for neuro-ophthalmic diagnosis.

The optimal utilization of magnetic resonance imaging in neuro-ophthalmic diagnosis is limited by errors in prescribing and interpreting scans. In a review of case material, we discovered four common prescriptive errors: 1) failure to apply a dedicated study, 2) inappropriate use of a dedicated study, 3) omission of intravenous contrast, and 4) omission of specialized sequences. The four common interpretive errors were the following: 1) failure to detect the lesion because of misleading clinical information, 2) rejection of a clinical diagnosis because an expected imaging abnormality was absent, 3) assumption that a striking imaging abnormality accounted for the clinical abnormality, and 4) failure to consider the lack of clinical specificity of imaging abnormalities. Many of these errors could be avoided by improved communication between clinicians and radiologists.

Artifacts↗