(1) Background: The King-Devick (KD) rapid number naming test is sensitive for concussion diagnosis, with increased test time from baseline as the outcome measure. Eye tracking during KD performance in concussed individuals shows an association between inter-saccadic interval (ISI) (the time between saccades) prolongation and prolonged testing time. This pilot study retrospectively assesses the relation between ISI prolongation during KD testing and cognitive performance in persistently-symptomatic individuals post-concussion. (2) Results: Fourteen participants (median age 34 years; 6 women) with prior neuropsychological assessment and KD testing with eye tracking were included. KD test times (72.6 ± 20.7 s) and median ISI (379.1 ± 199.1 msec) were prolonged compared to published normative values. Greater ISI prolongation was associated with lower scores for processing speed (WAIS-IV Coding, r = 0.72, p = 0.0017), attention/working memory (Trails Making A, r = −0.65, p = 0.006) (Digit Span Forward, r = 0.57, p = −0.017) (Digit Span Backward, r= −0.55, p = 0.021) (Digit Span Total, r = −0.74, p = 0.001), and executive function (Stroop Color Word Interference, r = −0.8, p = 0.0003). (3) Conclusions: This pilot study provides preliminary evidence suggesting that cognitive dysfunction may be associated with prolonged ISI and KD test times in concussion.
Optic nerve perineuritis targets the optic nerve sheath; it is idiopathic or a manifestation of systemic inflammatory diseases such as myelin oligodendrocyte glycoprotein (MOG) antibody syndrome, sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, or giant cell arteritis (GCA). 1 Radiographically, there is optic nerve sheath enhancement and, occasionally, orbital fat "streaking." 1 Biopsies have identified dural sheath lymphocytic infiltrate, perineural fibrous tissue, granulomas, or evidence of small-vessel vasculitis. 1 Retroperitoneal fibrosis (RPF) is defined by abdominal organ fibrosis. Usually idiopathic, it may be secondary to medication, radiation, or systemic inflammatory conditions. 2 Pathologically, its hallmark is fibrosis and infiltration of macrophages, B-lymphocytes, and T-lymphocytes. 2 Often considered when older patients present with headache or ischemic optic neuropathy, GCA is the most common largevessel vasculitis. 3 It has been proposed that GCA results from a T-cell-mediated inflammatory cascade, causing vascular intimal hyperplasia. 3 GCA has rarely been reported in association with RPF 4,5 or perineuritis. 6,7 We present a patient initially diagnosed with idiopathic RPF treated with immunosuppression, who subsequently developed optic perineuritis followed by GCA.
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