Graves ophthalmopathy (GO) is an autoimmune disorder and the most frequent extrathyroidal manifestation of Graves' disease. GO is an inflammatory process leading to an increased volume of the extraocular muscles and orbital connective and adipose tissues associated with multiple histopathological changes. Despite recent progress in the understanding of its pathogenesis, GO often remains a major diagnostic and therapeutic challenge. It has become increasingly important to classify patients into categories based on disease severity and activity. Low doses of radiotherapy (RT) have demonstrated a benefit in the treatment of moderate-to-severe GO with very few side effects. New RT techniques deliver a more conformal dose distribution to the target and decrease the dose to normal healthy tissue minimizing the risk of side effects. In this review we briefly analyzed the pathogenesis of GO and discussed the most relevant therapeutic approaches, with particular emphasis in the new RT technics. Appropriately designed and powered clinical studies are necessary to determine the most effective treatment with the lowest risk of side effects.
La arteria trigeminal persistente es una anomalía vascular poco común que se presenta como una comunicación entre la arteria carótida interna y el sistema vertebrobasilar. Esta anastomosis es importante debido a que asegura el correcto aporte sanguíneo del cerebro durante el desarrollo embrionario, que es la etapa más crítica. El diagnóstico, en la mayor parte de los casos, es un hallazgo accidental. En el 25% de los casos, la arteria trigeminal persistente se relaciona con algunas enfermedades cerebrales de tipo vascular, especialmente con aneurismas intracraneales, mientras que la repercusión neurooftalmológica no es frecuente. Se reporta el caso clínico de un paciente varón que desarrolla una proptosis, así como una oftalmoparesia completa del tercer par craneal con una variante anatómica de la normalidad, que consiste en una arteria trigeminal persistente detectada mediante resonancia magnética.
The persistent trigeminal artery (PTA) is a rare vascular anomaly which represents a persistent communication between the internal carotid artery and vertebrobasilar system. This anastomosis is important because it provides the main source of blood supply during the development of the embryonic brain in its most critical stage. The diagnosis, in the majority of cases, concerns an incidental finding. The 25% of the persistent trigeminal arteries are linked to some vascular brain diseases, especially with intracranial aneurysms, and neurophthalmologic involvement is not frequent. This case reports a male patient who developed proptosis and a complete ophthalmoparesis of the third cranial nerve with an anatomical variant of the normality consisting of a PTA detected by the magnetic resonance imaging.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.