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BMJ Case Rep 2021 May 10;14(5). Epub 2021 May 10.

Department of Neurosurgery, Tallahassee Neurological Clinic, Tallahassee, Florida, USA.

A 28-year-old man in 2004 was identified with a spontaneous pseudoaneurysm and distal left cervical internal carotid artery (ICA) dissection. The patient was followed conservatively for 12 years with cross-sectional imaging. The patient was initially diagnosed with an acute left ICA dissection, with significant luminal narrowing. Read More

Am J Case Rep 2021 May 5;22:e930504. Epub 2021 May 5.

Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

BACKGROUND Ocular siderosis is an uncommon cause of vision loss due to a retained ferrous intraocular foreign bodies (IOFB) that cause iron deposition in ocular tissues. The most common manifestations are cataract formation, diffuse pigmentary changes of the retinal pigment epithelium, iris heterochromia, dilated pupils, secondary glaucoma, iritis, and cystoid macular edema. CASE REPORT We report a case of 38-year-old man who presented with a left dilated pupil and visual field defect. Read More

Med Clin North Am 2021 May;105(3):511-529

Department of Ophthalmology, University of Pennsylvania, 51 N 39th St, Philadelphia, PA 19104, USA.

Neuro-ophthalmology is the study of the neurologic underpinnings of vision and includes a fascinating variety of disorders that span the broad spectrum of ophthalmic and neurologic disease. This subspecialty relies heavily on accurate neuroanatomic localization and examination. This article discusses neuro-ophthalmic complaints that frequently present to the internist, including acute vision loss, double vision, and unequal pupils. Read More

Neurochirurgie 2021 Apr 23. Epub 2021 Apr 23.

Service de neurochirurgie, hôpital Ibn Tofail, CHU Mohammed 6 Marrakech, Maroc. Electronic address:

Objective: To determine the severity factors in severe traumatic brain injuries.

Methods: A prospective descriptive study of severe head injuries admitted to the emergency department at Ibn Tofail Hospital at the University Hospital of Marrakesh over a period of six months from May to October 2015. The following data was collected: circumstances, clinical, biology, radiology, treatment and evolution. Read More

Turk J Med Sci 2021 Apr 23. Epub 2021 Apr 23.

Aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC).

Material And Methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). Read More

Surg Neurol Int 2021 30;12:133. Epub 2021 Mar 30.

Department of Neurosurgery, Faculty of Medicine, Kasr Al-Ainy Medical College, Cairo, Egypt.

Background: Cerebral venous sinus thrombosis (CVST) is not a common type of stroke (5%) but still hazardous to be misdiagnosed or mistreated. Aggressive medical treatment is usually failed to hinder increase intracranial tension. Therefore, decompressive craniectomy (DC) is the final measure to mitigate the deleterious effect of supratentorial herniation. Read More

Pediatr Neurosurg 2021 8;56(3):213-220. Epub 2021 Apr 8.

Department of Neurosurgery, University of Health Science, Bagcilar Training and Research Hospital, Istanbul, Turkey.

Aim And Background: Traumatic epidural hematoma (EDH) is a rare but possibly fatal complication of head trauma in infants. In this study, infants who were younger than 1 year and followed up and treated for TEDH in our clinic were evaluated. Our series is the largest series consisting only infantile cases in the literature. Read More

Eur J Med Genet 2021 Mar 30;64(6):104210. Epub 2021 Mar 30.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Institute for Rare Diseases, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel. Electronic address:

Kabuki syndrome (KS) is a genetic disorder caused by pathogenic variants in KMT2D or KDM6A, and manifesting with multi-systemic involvement, including recognizable facial features, developmental delay and multiple congenital anomalies. Ophthalmological involvement has been described in varying rates in several studies. We aimed to evaluate the prevalence and nature of ophthalmological findings in a cohort of KS patients in Israel. Read More

Cureus 2021 Feb 3;13(2):e13112. Epub 2021 Feb 3.

Internal Medicine, Saint Mary's Hospital, Waterbury, USA.

A 65-year-old man with 50 pack-year smoking history presented to the emergency department for evaluation of upper back and right shoulder pain secondary to a fall. Physical examination was notable for anisocoria with a constricted left pupil (miosis), mild ptosis of the left eyelid, and bilateral shoulder pain, right more than left, with both passive and active movements. Chest computed tomography identified a soft tissue mass at the left lung apex with extension into the pleural surface, associated with destructive osseous changes of the right scapula, adjacent ribs, and thoracic vertebral bodies. Read More

J Family Med Prim Care 2020 Dec 31;9(12):6273-6275. Epub 2020 Dec 31.

Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States.

A 57-year-old female presented with headache, miosis, and ptosis diagnosed as Horner syndrome (HS). After delaying the recommended diagnostic imaging, she experienced transient, unilateral visual impairment in bright light. The patient was subsequently determined to have a spontaneous internal carotid artery dissection (ICAD) and secondary retinal ischemia with minimal cardiovascular risk factors and no history of preceding trauma. Read More

Iran J Allergy Asthma Immunol 2021 Feb 11;20(1):125-128. Epub 2021 Feb 11.

Department of Pediatrics, Division of Pediatric Emergency, Faculty of Medicine, Gazi University, Ankara, Turkey.

Pharmacological anisocoria is a rare but benign condition. This paper presents an eleven-year-old patient with asthma who developed ipratropium bromide-associated anisocoria during nebulizer treatment. Hypotheses regarding the possible causes of anisocoria are discussed and precautions to be taken during treatment are presented. Read More

Sci Rep 2021 Feb 26;11(1):4744. Epub 2021 Feb 26.

Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy.

Trigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Read More

Int Ophthalmol 2021 Feb 25. Epub 2021 Feb 25.

Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstrasse 5, 79106, Freiburg im Breisgau, Germany.

Purpose: Based on findings of the Asian low-concentration atropine for myopia progression study, a concentration of 0.05% has been proposed as a good compromise between safety and efficacy for myopia control. However, no data on side effects have been published so far in Caucasian children receiving this dose. Read More

J Neuroimaging 2021 May 22;31(3):446-458. Epub 2021 Feb 22.

Department of Radiology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Pediatric patients are commonly referred to imaging following abnormal ophthalmological examinations. Common indications include papilledema, altered vision, strabismus, nystagmus, anisocoria, proptosis, coloboma, and leukocoria. Magnetic resonance imaging (MRI) of the brain and orbits (with or without contrast material administration) is typically the imaging modality of choice. Read More

Indian J Ophthalmol 2021 Mar;69(3):773-774

Bezmialem Vakif University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.

With increasing experience, it has been suggested that the SARS-CoV-2 virus has a neurotropic effect. Here, we present a case of a tonic pupil who developed after COVID-19 infection. A 36-year-old woman presented with progressive photophobia and blurred vision. Read More

Int J Surg Case Rep 2021 Feb 9;79:358-361. Epub 2021 Jan 9.

Department of Neurosurgery, Trauma and Burns Center, Ben Arous, Tunisia. Electronic address:

Introduction: Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children. TBI in children are responsible for a range of clinical symptoms and signs that are comparable to those in adults, but present several differences in both physiopathology and management. Many postoperative complications may occur, ischemic stroke among others, which is generally related to an injury of an intracranial artery. Read More

Cesk Slov Oftalmol 2020 ;76(5):232-235

The aim of the work is to approach the examination of the pupil with a focus on anisocoria, its characteristics and approach to the diagnosis of pupillotonia and Adie's syndrome and its clinical evaluation. Pupil function is important not only in neurophthalmological examination but also in general ophthalmological examination. First of all, we need to know how the reflex arc works in order to be able to exclude or confirm whether the parasympathetic or sympathetic is affected. Read More

No Shinkei Geka 2021 Jan;49(1):193-197

Department of Neurosurgery, Tannan Regional Medical Center.

There have been few reports about acute brain swelling caused by unruptured aneurysm surgery. We report a case of fatal acute brain swelling after clipping of an unruptured anterior communicating artery aneurysm following lung cancer surgery. A 65-year-old man underwent aneurysm neck clipping for an unruptured anterior communicating artery aneurysm by interhemispheric approach 35 days after curative resection of lung cancer. Read More

CVIR Endovasc 2021 Jan 11;4(1):14. Epub 2021 Jan 11.

Department of Radiology; Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 E. Medical Center Dr, B1D502, 48109-5030, Ann Arbor, MI, USA.

Background: Congenital portosystemic shunts are embryological malformations in which portal venous flow is diverted to the systemic circulation. High morbidity and mortality are seen in patients with concurrent hepatic encephalopathy, hepatopulmonary syndrome, and pulmonary hypertension. Endovascular therapy, in the correct patient population, offers a less invasive method of treatment with rapid relief of symptoms. Read More

Neurosurg Rev 2021 Jan 7. Epub 2021 Jan 7.

Department of Neurosurgery, Kyorin University Hospital, Tokyo, Japan.

While intracerebral hemorrhage (ICH) scoring systems provide mortality and morbidity prediction, the actual mortality rates seem to be lower than those predicted by scoring systems in our clinical impression. To assess the validity of the ICH score and the Surgical Swedish ICH (SwICH) score, we retrospectively reviewed surgically treated ICH patients between 2012 and 2019. Uni- and multivariate analyses were performed to identify variables in predicting 30-day mortality. Read More

Optom Vis Sci 2021 Jan;98(1):18-23

Wenzhou Medical University, Wenzhou, Zheniang, China.

Significance: A new device attached to a smartphone was created for objective vision screening of young children including infants and newborns. The device is compact, lightweight, portable, cost-effective, and easy to operate. Therefore, it is suitable for screening large numbers of children in clinical settings, schools, and communities. Read More

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

Department of Paediatrics, Ysbyty Gwynedd, Bangor, UK

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. Read More

J Cataract Refract Surg 2021 May;47(5):676

From the Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, Utah (Moshirfar, McCabe); John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, Utah (Moshirfar); Utah Lions Eye Bank, Murray, Utah (Moshirfar); McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas (Hall); University of Utah School of Medicine, Salt Lake City, Utah (West).

Int J Neurosci 2021 Mar 8:1-6. Epub 2021 Mar 8.

Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Background: Granulocytic sarcoma (GS), is also referred to as myeloid sarcoma. It is a solid mass formed by the primitive or immature myeloid cells extramedullary infiltration, which is commonly caused by acute myelogenous leukemia (AML) or chronic myelogenous leukemia (CML). It mainly involves bones, lymph nodes, skin and soft tissues of the head and neck. Read More

BMJ Case Rep 2020 Nov 30;13(11). Epub 2020 Nov 30.

Paediatrics, Unidade Local de Saude de Matosinhos EPE, Senhora da Hora, Portugal.

Here we report a case of a term newborn presenting with left palpebral ptosis, anisocoria and heterochromia as well as cleft palate and heart murmur. Congenital Horner syndrome was suspected and a thoracoabdominal CT scan was performed to rule out neuroblastoma. This revealed an anomalous drainage of right pulmonary veins to a collector that drains to the inferior vena cava, leading to the diagnosis of Scimitar syndrome. Read More

Indian J Ophthalmol 2020 Dec;68(12):3070-3072

Department of Cornea and Refractive Surgery, Anand Eye Institute, Hyderabad, Telangana, India.

A young lady presented with very high vault and fixed dilated pupil along with optic capture of the implantable collamer lens (ICL). After thorough evaluation and ruling out the ICL sizing error, the optic capture was relieved and the ICL was rotated into vertical position. Single-pass four throw pupilloplasty was performed for the fixed dilated pupil. Read More

Neurology 2021 04 18;96(15):719-722. Epub 2020 Nov 18.

From the Departments of Ophthalmology (E.W., S.A.M., J.J.C., M.T.B.) and Neurology (J.J.C., M.T.B.), Mayo Clinic College of Medicine, Rochester, MN.

Europace 2021 Apr;23(4):581-586

Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.

Aims: The adoption of percutaneous stellate ganglion blockade for the treatment of drug-refractory electrical storm (ES) has been increasingly reported; however, the time of onset of the anti-arrhythmic effects, the safety of a purely anatomical approach in conscious patients and the additional benefit of repeated procedures remain unclear.

Methods And Results: This study included consecutive patients undergoing percutaneous left stellate ganglion blockade (PLSGB) in our centre for drug-refractory ES. Lidocaine, bupivacaine, or a combination of both were injected in the vicinity of the left stellate ganglion. Read More

Brain Res 2021 01 4;1751:147194. Epub 2020 Nov 4.

Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. Electronic address:

It has been observed that, in patients affected by temporomandibular disorders (TMDs) and edentulism, a left-right asymmetry in electromyographic (EMG) activity of masseter muscles during clenching and in pupil size at rest (anisocoria) is present. Both are greatly reduced by an orthotic-prosthetic correction. In parallel, the correction significantly improves cognitive performance. Read More

J Neurosci Rural Pract 2020 Oct 4;11(4):601-608. Epub 2020 Sep 4.

Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, La Victoria, Lima, Perú.

 Determine predictors of in-hospital mortality in patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy.  This retrospective study reviewed consecutive patients who underwent a decompressive craniectomy between March 2017 and March 2020 at our institution, and analyzed clinical characteristics, brain tomographic images, surgical details and morbimortality associated with this procedure.  Thirty-three (30 unilateral and 3 bifrontal) decompressive craniectomies were performed, of which 27 patients were male (81. Read More