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At least 271 records · Page 15Linked to original sources
PubMed1983

Posterior ischemic optic neuropathy. III. Clinical diagnosis.

14 cases of posterior ischemic optic neuropathy (PION) were clinically analyzed, in whom we excluded known etiologies of optic nerve disturbances and confirmed the decreased blood supply to the posterior portion of the optic nerve. On the basis of our clinical findings, we have proposed the following criteria for the diagnosis of idiopathic PION: (1) sudden onset of unilateral visual disturbance in older patients; (2) normal optic disc, subsequently developing simple optic atrophy; (3) hypertensive and arteriosclerotic changes in the retinal vessels; (4) varying degrees of impaired vision, variable visual field defects; (5) associated systemic disease such as hypertension, diabetes mellitus, hyperlipemia, hypotension, etc.; (6) exclusion of other demonstrable causes of optic nerve disturbances, and (7) confirmation of abnormal hemodynamics in the posterior portion of the optic nerve by carotid angiography, ophthalmodynamography, ophthalmodynamometry and fluorescein fundus angiography.

Adult↗
PubMed1986

Retinal artery pressure and cerebral artery perfusion pressure in cerebrovascular occlusive disease.

The objectives of the investigation were to measure the retinal artery pressure (RAP) and cortical artery pressure (CAP) in patients undergoing superficial temporal artery to middle cerebral artery (STA-MCA) bypass, to study the relationship between these pressures, and to evaluate our ability to predict CAP on the basis of RAP. The 44 patients undergoing bypass surgery included 26 with ipsilateral internal carotid artery (ICA) occlusion (Group I), 5 with bilateral ICA occlusion (Group II), 4 with inaccessible ICA stenosis proximal to the ophthalmic artery (OA) (Group III), 2 with ICA stenosis distal to the OA (Group IV), 3 with ICA occlusion distal to the OA (Group V), 2 with MCA stenosis (Group VI), and 2 with MCA occlusion (Group VII). Five patients undergoing craniotomy for an asymptomatic saccular aneurysm were used as controls. Mean RAP (MRAP) was measured by ophthalmodynamometry (ODM) and was expressed as a ratio of the mean systemic arterial blood pressure (i.e., MRAP/MSAP). The mean MRAP/MSAP for combined Groups I, II, and III with ICA occlusion proximal to the OA was significantly lower than both the control group (P = 0.0001) and the combined Groups IV, V, VI, and VII with occlusive lesions distal to the OA (P = 0.0001). Six patients in Groups I and II with venous stasis retinopathy had a mean MRAP/MSAP of 0.18 +/- 0.11. Mean cortical artery pressure (MCAP) was measured by inserting a 26 gauge needle into a small cortical artery and was expressed as the MCAP/MSAP ratio. Mean MCAP/MSAP was less than 0.50 for all groups except Group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMedDate not supplied

Optimized graphical analysis of Gaussian and lognormal assumptions for intraocular and vascular pressure distributions.

The design of optimized histogram and probability graphs needed to detect a lognormal distribution in surveys of intraocular pressure (IOP), mean ophthalmic arterial pressure (OAP) and mean ocular perfusion pressure (OPP) is described. Applications are demonstrated in a sample of 58 normal adult eyes. A lognormal distribution was found for IOP and for OAP and OPP estimates obtained with a noncontact noncompressive method. Conversely, the absence of an identifiable linear distribution for OAP and OPP estimates obtained with compression ophthalmodynamometry was noteworthy. The implications of lognormality for definitions of a normal range and for correlations involving IOP, OAP and OPP data are briefly discussed.

Adult↗
PubMed1981

Neurosurgical applications of ocular pneumoplethysmography.

Ocular pneumoplethysmography (OPG), a semiautomated form of suction ophthalmodynamometry, was used to evaluate and follow 15 patients who underwent carotid endarterectomy and two patients in whom gradual carotid artery occlusion was performed for inoperable intracranial aneurysm. Postoperative corrected ophthalmic arterial pressures (COAP's) on the operated side in the carotid endarterectomy patients averaged 12.5 mm Hg higher than before surgery, the standard deviation being 4.9 mm Hg for clinically stable patients. There was no significant change in COAP on the contralateral side. Several problems were encountered in closing down carotid clamps, the most potentially serious being a precipitous fall in COAP with the final adjustment. The current uses of OPG and similar techniques are reviewed, and potential neurosurgical applications are discussed.

Blood Pressure↗
PubMed2003

[Pathophysiological basis for decompression surgeries and their effect on the optic nerve scleral duct in cases of primary glaucoma].

The visual functions and hemodynamics of the optic-nerve and retina were examined before and after decompression surgeries in the optic nerve. The methods of ophthalmodynamometry and ultrasound dopplerography were used to study the optic-nerve hemodynamics. The results showed an essential improvement in the visual field and blood circulation of the optic nerve in 80.7% of operated patients. The obtained data are indicative of that a disturbed blood circulation in the optic-nerve initial portion plays an important role in the development and progressing of glaucomatous optic neuropathy. Decompression surgeries in the optic nerve in cases of a progressing worsening of the visual functions are pathogenetically substantiated for glaucomatous patients.

Decompression, Surgical↗
PubMedDate not supplied

Acute conformational changes in the optic nerve head with rapid intraocular pressure elevation: implications for LASIK surgery.

BACKGROUND AND OBJECTIVE: To investigate the effects of acute intraocular pressure (IOP) elevation on optic disc morphology. PATIENTS AND METHODS: Ophthalmodynamometry was used to increase the IOP of normal, healthy eyes. Confocal scanning laser ophthalmoscopy of the optic nerve head using the Heidelberg Retinal Tomograph II (Heidelberg GmbH, Heidelberg, Germany) and IOP measurements were obtained before, during, and after IOP elevation. RESULTS: Sixteen eyes of 16 normal volunteers (mean age, 32.8 +/- 11.9 years) were enrolled. Rim area, rim volume, cup area, cup volume, cup-to-disc ratio, mean cup depth, maximum cup depth, mean retinal nerve fiber layer (RNFL) thickness, and RNFL cross-sectional area showed significant changes during IOP elevation (all P < .05, paired t test). All measured parameters returned to their original values after pressure resolution (all P > .2) except mean RNFL thickness (P = .03). CONCLUSION: Transient elevation of IOP results in measurable alterations in optic nerve head topography.

Adult↗
PubMedDate not supplied

[The significance of concurrent vertebrobasilar insufficiency in postanesthesia recovery].

A study of 149 patients was carried out, who had cervical osteochondrosis, by using the stage-based narcosis and general intravenous anesthesia. The parameters of the peripheral velocity of the bloodstream in the direct brain venous sine were examined by transcranial dopplerography. Preoperatively, the patients were shared between 3 groups with due respect to clinical and neurological symptoms as well as to X-ray-registered changes in the cervical spine. While evaluating the intracranial pressure, the cerebral hemodynamics was examined by ophthalmodynamometry procedures (diastolic pressure in the retinal central vein). The anatomotopographic peculiarities of the cervical spine, and in particular, of the spinal artery, vein and sympathetic nerve passage, as observed in the lateral vertebral processes in cases of spine osteochondrosis, aggravate the strangulation and blood circulation disturbances in the basilar and vertebral regions with respect to changes of the head position. Trachea incubation (head extended with anesthetic management), made in patients with the pronounced cervical osteochondrosis (group III), slowed down the peripheral blood flow into the direct brain venous sine; it also caused a higher intracranial pressure versus the parameters observed in the basilar and vertebral deficiency, as well as hemodynamics instability resulting in a late awakening after anesthetic management.

Adult↗
PubMed1988

Indications for endarterectomy and STA-MCA shunts in the brain atherosclerosis.

Altogether 169 operations of patients with occlusion or stenosis of the brain arteries and brain magistral arteries are reviewed. In 151 patients the cause of disease was atherosclerosis. No one of the patients has died. According to the thorough investigation consisting of panangiography, dynamic scintigraphy, sonography, ophthalmodynamometry, CT and other clinical investigations, either extra-intra-cranial shunts (STA MCA), or endarterectomies were carried out. The indications for these operations were elaborated with regards to the cause of tandem changes in arteries or to bilateral atherosclerotic changes of the brain arteries. Out of the total 169 operations, 30 endarterectomies were performed. Only two post-surgical complications have appeared, one of them post STA MCA operation and the other after endarterectomy.

Adolescent↗
PubMedDate not supplied

[Clinical symptoms of stenosis and occlusion of the carotid arteries].

In 174 patients with carotid artery changes confirmed by angiography or autopsy the syndromes of clinical manifestations characteristic of stenosis or occlusion of the internal carotid artery, common carotid artery, external carotid artery were analyzed. Particular attention was given to prodromal symptoms and signs of the disease and non-invasive auxiliary-investigations such as ophthalmodynamometry, ultrasound examination of arteries based on Doppler's phenomenon, and EEG. The role of the effect of its stenosis or occlusion on the condition of patients with associated occlusion of one internal carotid artery are discussed.

Arterial Occlusive Diseases↗
PubMed1986

[Effect of strophanthin on the status of systemic and cerebral hemodynamics in patients with ischemic stroke].

The effect of strophanthin (S) on the status of the general and cerebral hemodynamics was investigated in 35 patients with ischemic stroke (IS). The central hemodynamics was studied with the help of dye dilution. The blood circulation in the system of the internal carotid artery was determined with the help of ophthalmoplethysmography and ophthalmodynamometry. S was infused intravenously in daily doses of 0.25 ml of 0.05% solution. S had a positive inotropic influence on the myocardium; the diastolic retinal pressure simultaneously decreased while the minute volume of blood in the eyes increased. The authors substantiate the possibility of the direct effect of S on the tonus of the cerebral vessels and advisability of its application in patients with IS even when there are no evident clinical signs of chronic cardiac failure.

Aged↗
PubMed1978

[Ophthalmocalibrometric assessment of the state of the microcirculation in the retinal vessels in transient disorders of cerebral circulation].

The report analyses some results of a neuro-ophthalmological study of 82 patients from 34--76 years (37 males and 45 females) with transient disorders of cerebral circulation. Besides clinical studies the authors applied EEG and REG registrations, studies of the lipid metabolism, coagulative and anticoagulative blood systems. Ophthalmological studies included the assessment of visual acuity with and without correction, quantitative perimetry, the determination of a genuine intra-ocular pressure, ophthalmodynamometry, biomicroscopy of the conjunctiva and episclera, biomicro-ophthalmoscopy, ophthalmoscopy with the use of electro-ophthalmoscopy, a large nonreflex ophthalmoscope, ophthalmocalibrometry. By means of ophthalmocalibtometrical studies the authors established an existence of expressed pathology of microcirculation in the form of a marked narrowing of arterioles and a dilatation of the venoules with a significant decrease of the arterio-venous correlations. The achieved data are analyzed with consideration of the etiology, development and topography of transient disorders of cerebral circulation.

Adult↗
PubMed1983

[Complex ultrasonic scanning, Doppler sonography, telethermography and infrared radiometry in studies of carotid artery circulation].

The authors first applied a complex of modern noninvasive methods of studying cerebral vascular pathologies, both direct (phonoangiography, echopulso- or echosphygmography, bidimensional scanning) and indirect (telethermography, ultrasound flowmetry, photoplethysmography and ophthalmodynamometry, inhalation radiocirculography) in examining patients with various stages of atherosclerotic carotid impairment and various forms of cerebral vascular pathology (ischemic stroke, transient disorders of the cerebral circulation, initial manifestations of cerebral circulation deficiency) verified by cerebral angiography, surgery or necropsy findings. High informative value of the above methods used combined in cases of circulatory pathology in the carotid bed was shown and the differential evaluation of the importance of every individual method in concrete types of cerebrovascular pathology was carried out. The use of ultrasound and thermovisual methods is considered to be most promising in the diagnosis of vascular cerebral impairments.

Adult↗
PubMed1983

[Extra-intracranial bypass and internal carotid artery ligation in one-stage operation for intracavernous and giant carotid aneurysm].

The combined one-stage operations, STA-MCA anastomosis and internal carotid artery (ICA) ligation (or trapping) were carried out in 11 cases (Age): 18-79 yrs, Av.: 45.8 yrs) of ICA aneurysms which were inaccessible for a direct operation because of their locations and sizes. First the STA-MCA anastomosis was performed under general anesthesia. Then the patient was awaken and thereafter under local anesthesia the ICA was temporarily clamped for 30 min. under induced hypotension to check whether any ischemic signs appeared. This was followed by proximal ICA ligation when no ischemic signs were observed. In all 11 cases, the anastomosis was patent. The aneurysms disappeared. Neither cerebral ischemia nor rebleeding from the aneurysms was seen during the long follow-up. The mean value of the bypass flow was 119 m/min which was twice as much as that in the cases of other occlusive cerebrovascular diseases and which was about one third of the blood flow of the ICA. Cerebral blood flow measurements through 133Xe inhalation method revealed that there was no difference in rCBF values between the operated and non-operated sides and that their values were within normal limits. The postoperative blood pressure was unchanged in 42% of our 11 cases, temporarily elevated and thereafter normalized in 33% and persistently elevated in 25%. Ophthalmodynamometry showed that the pressure of the central retinal artery decreased postoperatively in a degree of 5-10% in comparison to the non-operated side. No visual impairment was observed postoperatively (except case 3, see the text). These combined operations, STA-MCA anastomosis and ICA ligation were beneficial in preventing the potential postoperative cerebral ischemia. Intra-arterial pressure measurements of the STA and MCA suggested that the one-stage operations of these two procedures are better than the two-stage operations for the patency of the anastomosis because the pressure gradient between the donor and recipient vessels is increased (from 10.3 mmHg to 49.3 mmHg) by this technique. Temporary ICA clamp for 30 min. under induced hypotension in local anesthesia is useful to check whether the one-stage operations can be tolerated or not. EC/IC bypass with an interposed saphenous vein graft is a more beneficial surgical technique than a routine STA-MCA anastomosis, because an immediate and larger amount of bypass flow can be obtained.

Adult↗
PubMed1980

[Giant aneurysm of the internal carotid artery, stimulating parasellar tumor].

The authors report a case of a giant aneurysm of the internal carotid artery filling from the left internal carotid artery below the site of branching-off of the posterior communicating artery. The initial neurological, and ophthalmological signs and plain films of the skull suggested presence of an Erdheim's tumour. It is worth stressing that the onset of the clinical manifestations was at the age of 15 years, particularly in the form of progressing binasal hemianopsia with sparing of the lower temporal quadrant. The efficiency of the cerebral circulation was tested using Mathas' test, electroencephalography, ophthalmodynamometry and angiography. It was decided to ligate the left carotid artery although Mathas' test during angiography was not as positive. The boy tolerated the operation well. Ophthalmological examination demonstrated after 18 months normal visual fields and normal visual acuity. Further follow-up during 8 years demonstrated normal psychosomatic development of the boy.

Adolescent↗
PubMed1978

The ocular aspects of carotid artery bypass surgery.

A new neurosurgical procedure, anastomosis of the superficial temporal artery to the middle cerebral artery, is being performed with increasing frequency. Over a 7-year period (1971 through 1977), 121 patients have undergone this operation in our institution. Ophthalmodynamometry may be of great help in identifying occlusion of an internal carotid artery. Progressing venous stasis retinopathy and ischemic orbital pain are believed to be indications for bypass surgery of the carotid artery.

Blood Pressure↗
PubMed1964

QUININE AMBLYOPIA.

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Abortion, Illegal↗