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Biomedical subjects

N R Miller

Publications and source records attributed to N R Miller.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Neuro-ophthalmologic dilemma: chronic optic neuritis?

A patient with an 8-month history of chronic progressive visual loss was referred to the Neuro-ophthalmology Consult Office of Washington University with a diagnosis of chronic optic neuritis. Previous diagnostic studies, including CAT scan, had been negative. Because chronic progressive visual loss is considered a hallmark of mass lesion, more vigorous investigation, including repeat CAT scans, was undertaken, leading to the diagnosis and removal of a 2 cm meningioma.

Adult↗
PubMedDate not supplied

Giant cell (temporal) arteritis. The differential diagnosis.

A patient was referred to the neuro-ophthalmology unit with a diagnosis of Foster-Kennedy syndrome; "papilledema" had been noted in the right eye and optic atrophy in the left. Results of radiographic examinations and lumbar puncture had been normal. The considerations and procedures leading to a correct diagnosis of giant cell arteritis are discussed.

Aged↗
PubMedDate not supplied

Progressive visual loss associated with peculiar disc swelling.

A patient with progressive visual loss associated with swelling of the disc presented the classic clinical picture of Leber's optic neuropathy. The hereditary patterns, diagnostic characteristics and natural history of the disease are discussed. Although there is no efficacious treatment for Leber's optic neuropathy available at this time, correct diagnosis is important for purposes of genetic counseling and avoidance of unnecessary neuroradiologic and surgical procedures.

Adult↗
PubMedDate not supplied

Pseudotumor cerebri.

The authors evaluate the case of a 20-year-old, four-month-pregnant woman who presented with papilledema and visual field loss, and developed headache, intermittent diplopia and impairment of color vision over the next month. The procedures and considerations leading to the diagnosis of pseudotumor cerebri are discussed, as are the various modes of therapy and their indications.

Adult↗
PubMedDate not supplied

Optic neuritis--etiology?

A 44-year-old otherwise healthy woman was referred to Washington University with previous diagnoses of para planitis and retrobulbar neuritis, and with a current complaint of markedly decreased vision (light perception only) in the right eye. Among the findings at the time of this evaluation were posterior uveitis and evidence of optic neuropathy and of a disordered immune system. The patient responded to pulsed high-dose corticosteroid therapy. A subsequent similar episode in the left eye also was resolved with such treatment. Dr. Burde describes the case in detail and asks Drs. Keltner, Gittinger and Miller to offer diagnoses. Their answers vary considerably.

Adult↗
PubMedDate not supplied

Endocrinological associations of pituitary tumors.

The patient presented with poor vision (particularly OS) which had declined progressively over ten years. He had had bifrontal headaches over the past two years. Examination and visual field testing showed optic atrophy and a bitemporal hemianopia. Procedures leading to the diagnosis of pituitary adenoma are discussed, as are treatment modalities and association of pituitary adenomas with other entities.

Adenoma, Chromophobe↗
PubMedDate not supplied

Glaucomatous cupping -- sine glaucoma.

A 72-year-old man presented with transient episodes of gradually descending vision loss in either eye. Both discs showed marked cupping, but applanation tensions were normal. Carotid occlusions were present. The etiology of the transient visual disturbances, the relationship of carotid disease to low tension glaucoma, and the management of such patients are discussed.

Aged↗
PubMedDate not supplied

Downbeat nystagmus.

A patient with downbeating nystagmus in the primary position and vertical saccadic pursuit is presented. The possible etiologies of these features and their diagnostic significance is discussed.

Aged↗
PubMedDate not supplied

Central visual dysfunction with disc swelling.

A healthy 17-year-old white male suffered sudden painless onset of visual loss in the right eye. The affected eye had a cecocentral scotoma, marked disc swelling with hyperemia and flame-shaped hemorrhages, and subretinal fluid extending into the macular area. The authors each consider the differential diagnosis, indications for treatment, the natural course, and the likelihood of association with various systemic diseases.

Adolescent↗
PubMedDate not supplied

Acquired diplopia. Not always a neurologic problem.

A case is presented in which a 49-year-old man has had progressive proptosis and diplopia over a six-week period without pain, loss of vision, or history of other ophthalmic or systemic disorders. The diagnostic work-up leading to a diagnosis of thyroid ophthalmopathy in such cases is discussed. Although the orbitopathy usually has a self-limited course, major complications are corneal exposure and optic neuropathy. The several modes of therapy available to treat these complications (systemic corticosteroids, orbital radiation, and orbital decompression are described.

Diplopia↗
PubMedDate not supplied

Branch artery occlusion in a young woman.

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.

Adult↗