• 제목/요약/키워드: optic nerve

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안와골절 수술 후 발생한 신경손상 (Nerve Injuries after the Operations of Orbital Blow-out Fracture)

  • 최재일;이성표;지소영;양완석
    • 대한두개안면성형외과학회지
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    • 제11권1호
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    • pp.28-32
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    • 2010
  • Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.

광릉늑대거미(Arctosa kwangreungensis) 중추신경계 발생에 관한 연구 (Development of the Central Nervous System in the Wolf Spider Arctosa kwangreungensis (Araneae: Lycosidae))

  • 양성찬;문명진
    • Applied Microscopy
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    • 제42권2호
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    • pp.77-86
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    • 2012
  • 배회성거미류인 광릉늑대거미(Arctosa kwangreungensis)를 실험재료로 배후발생에 따른 거미 중추신경계의 형태적 분화와 그 조직학적 변화를 관찰하였다. 식도를 중심으로 위쪽의 식도상신경절과 아래쪽의 식도하신경절이 서로 연결된 구조를 지닌 광릉늑대거미의 중추신경계는 부화가 이루어지는 후기배아 시기 이전에 확립되었고, 전대뇌(protocerebrum) 영역도 구분되었다. 후기배아 단계에서는 시각정보를 수용하는 시엽(optic lobe)의 발달이 미진하였으나 알주머니를 벗어나 본격적인 먹이활동을 시작하는 제2령 시기를 전후하여 성체와 동일한 신경계의 체제가 구축되었다. 후기배아 시기에 관찰된 식도상신경절의 미분화 세포들로부터 시각기 신경절이 발생되었고, 식도하신경절에서는 네 쌍의 부속지 신경절과 복부 신경절이 분화되었다. 또한, 발생 중인 유충의 중추신경계에서는 조직학적 특성이 다른 세 유형의 신경세포들이 관찰되었고, 발생단계에 따라 이들 세포집단의 이동과 분포상의 차이가 확인되었다.

Microstructural Organization of the Central Nervous System in the Orb-Web Spider Araneus ventricosus (Araneae: Araneidae)

  • Park, Yong-Ki;Moon, Myung-Jin
    • Applied Microscopy
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    • 제43권2호
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    • pp.65-74
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    • 2013
  • Although the geometrical difference in body position between web-building and wandering spiders could affect the organization of their central nervous system (CNS), however most of our informations about spider's CNS are dependent on those revealed from the wandering spiders. Therefore, this paper describes microstructural organizations of the CNS in the geometric orb-web spider Araneus ventricosus. Similarly to other wandering spiders, the CNS of A. ventricosus is also consisted of a dorsal supraesophageal ganglion and a ventral subesophageal mass. The supraesophageal ganglia are fused together and made up of a large sized nerve cell clusters, whereas the subesophageal ganglia are made up of the foremost part of the ventral nerve cord. It has been revealed that the only nerve arising from the supraesophageal mass was the optic nerve which connected with four pairs of eyes, whereas a pair of pedipalpal and four pairs of appendage nerves including abdominal nerve pairs were arisen from the subesophageal nerve mass. Fibrous masses are highly organized into longitudinal and transverse tracts, and are only consisted of processes of neurons and the terminal ramnifications of peripheral sensory neurons. In addition, central fibrous mass of both the brain and the subesophageal mass are totally devoid of nerve cell bodies.

사렵체 DNA의 11778 점돌연변이가 확인된 Leber씨 유전성 시신경병증 1례 (A Case of Leber's Hereditary Optic Neuropathy Showing 11778 Point Mutation of Mitochondrial DNA)

  • 정윤석;박승권;이승엽;하정상;박미영;이세진;이준
    • Journal of Yeungnam Medical Science
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    • 제16권1호
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    • pp.114-118
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    • 1999
  • LHON은 사립체 DNA의 점돌연변이에 의해서 유발되며 11778, 3460, 14484의 세 부위가 주된 사립체 DNA 점돌연변이의 위치로 알려져 있다. 이에 저자들은 점진적인 시력 저하를 호소하면서 사립체 DNA 분석 결과 11778 점돌연변이가 확인된 LHON환자 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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클로르페나피르 음독 후 발생한 독성 시신경병증 1예 (Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning)

  • 박수진;정재욱;강용구;전보영;손병재
    • 대한안과학회지
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    • 제59권11호
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    • pp.1097-1102
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    • 2018
  • 목적: 클로르페나피르 음독 후 중추신경계 손상을 동반한 독성 시신경병증 1예를 보고하고자 한다. 증례요약: 44세 여자가 7일 전부터의 양안 시력저하를 주소로 내원하였다. 환자는 내원 2주 전 자살 목적으로 클로르페나피르 한 모금을 음독했고, 직후 근처 병원에서 위세척을 시행하였다. 초기 최대교정시력은 우안 안전수지 30 cm, 좌안 안전수동이었다. 양안 동공은 5.0 mm로 커져 있었고, 빛에 대한 반응은 느렸으며 좌안에는 상대구심동공운동장애가 관찰되었다. 안저검사에서 양안 시신경유두부종이 관찰되었고, 뇌자기공명영상에서 양안 시신경과 속섬유막, 뇌량, 중소뇌각, 뇌간 등 백질 신경로를 따라 양쪽에 대칭적인 고강도신호가 관찰되었다. 클로르페나피르 중독으로 인한 독성 시신경병증으로 진단 후, 고용량 스테로이드치료를 3일간 시행하였으나 양안 최대교정시력은 광각무로 악화되었다. 3개월 후, 안저검사에서 양안 시신경위축이 관찰되었고, 빛간섭단층촬영에서 망막신경섬유층 및 신경절세포-내망상세포층 두께가 감소하였다. 결론: 매우 적은 양이라도 클로르페나피르에 노출되면 적절한 치료에도 불구하고 잠복기를 거쳐 심각한 시신경손상이 발생할 수 있으므로 주의해야 하겠다.

Infraoptic Course of Both Anterior Cerebral Arteries

  • Ji, Cheol;Ahn, Jae-Geun
    • Journal of Korean Neurosurgical Society
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    • 제47권1호
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    • pp.71-73
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    • 2010
  • A 28-year-old woman was referred to our hospital with a sudden, very severe headache. Brain computed tomographic angiography showed a saccular cerebral aneurysm at the bifurcation of the left middle cerebral artery and infraoptic courses of both anterior cerebral arteries. The anterior cerebral arteries were seen to arise from the ipsilateral internal cerebral arteries at the level of the origin of the ophthalmic artery, passed underneath the ipsilateral optic nerve, and turned upward at ventral portion of the optic chiasm. Infraoptic course of the proximal anterior cerebral artery is an extremely rare anomaly and is often associated with cerebral aneurysms. We report the clinical features, radiological findings, and possible genesis of this anomaly with a literature review.

Pituitary Apoplexy Presenting as Isolated Third Cranial Nerve Palsy with Ptosis : Two Case Reports

  • Cho, Won-Jin;Joo, Sung-Pil;Kim, Tae-Sun;Seo, Bo-Ra
    • Journal of Korean Neurosurgical Society
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    • 제45권2호
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    • pp.118-121
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    • 2009
  • Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function.

내과질환에 대한 Chiropratic Spinal Manipulation의 적용 - pubmed를 중심으로 검색 - (A Review of Journals on the spinal manipulation treatment applied to internal disease)

  • 권오봉;송윤경;임형호;이종수
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.61-72
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    • 2006
  • Objectives: The aim of this study is to investigate chiropractic spinal manipulation and internal diseases in articles. Methods: It was investigated how many articles had been searched for spinal manipulation applied to internal disease in Pubmed Database Results: 1. There are 19 articles of chiropractic spinal manipulation and internal diseases were investigated. 2. It was reported that there are improvements of spinal manipulative therapy on asthma, injury of the optic nerve, hypertension, vertigo, tinnitus, hearing loss, etc. Conclusions: There are several reports on effectiveness of spinal manipulative therapy on asthma, injury of the optic nerve, hypertension, vertigo, tinnitus, hearing loss, etc. And It is considered that spinal manipulative therapy shows improvement on the internal diseases.

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Development of Computerized Densitometry for the Quantitative Analysis of Diffuse Retinal Nerve Fiber Layer Atrophy

  • 이재성;박광석;이가영;김동명
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.146-149
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    • 1997
  • Computerized densitometry was developed or the quantitative measurement of diffuse retinal nerve fiber layer (RNFL) atrophy and intra- and inter-operator reliability and clinical validity of this system were evaluated. Vertical diameter, center of the optic disc, and peripapillary circles which had radii of 1.5 and 2.5 times that of the optic disc were user-interactively determined in digitized RNFL photograph and density profile along each circle was measured and normalized. The areas under the normalized density profiles of the superior and the inferior segments in both circle were used or the study of RNFL. To determine the variability and correspondence in the measurements of density variations, 21 RNFL photographs of glaucoma patients which showed varying degrees of atrophy underwent computerized densitometry by two operators on two separate occasions. Coefficient of variation in the densitometric measurements was $1.2{\sim}5.4%$. Intra- and inter-operator reliabilities were excellent. The correlations between the densitometric values and mean deviations of Humphrey C30-2 visual field showed statistical significance. Computerized densitometry of RNFL photographs was useful in the objective and quantitative assessment of diffuse RNFL atrophy.

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정상인과 녹내장 환자의 혈청 인지질 지방산 농도 (Fatty Acid Concentration of Serum Phospholipids in Normal and Glaucoma Patients)

  • 정혜연
    • 한국식생활문화학회지
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    • 제35권2호
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    • pp.224-232
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    • 2020
  • Glaucoma is one of the leading causes of blindness worldwide and is characterized by degeneration of the optic nerve. Elevated intraocular pressure (IOP) is the major contributing factor to optic nerve damage. However, some patients develop glaucoma even with normal IOP. Other factors, including age, race, myopia, and nutrition, can affect glaucoma risk. Dietary fat intake and serum fatty acid composition are closely related with the fatty acid profile of the retina and thus can modulate glaucoma risk. In this study, we collected serum samples from 34 glaucoma patients (26 primary open angle glaucoma (POAG) and 8 normal tension glaucoma (NTG)) and 45 healthy controls and analyzed their serum phospholipid fatty acid concentrations. The results show that the ratio of oleic acid to stearic acid (OA/SA), which is an indicator of stearoyl-CoA desaturase activity, was higher in POAG patients when compared to normal controls. The ratio of eicosapentaenoic acid to arachidonic acid (EPA/AA), which is an indirect marker of eicosanoid biosynthesis, was also higher in glaucoma patients (p=0.048). These results imply that dietary fatty acid intake and serum fatty acid profile can influence glaucoma risk. Additional study is necessary to identify the relationship between fatty acids and glaucoma.