A 10-year-old girl developed bilateral blindness and partial third nerve paresis immediately following a closed head injury. Bilateral optic atrophy developed subsequently. This is the first report of an association between second and third nerve injuries after minor head trauma in the absence of a preexisting lesion. The pathophysiology of indirect injury to the optic nerve under these circumstances is uncertain, but the lesions in this patient seemed to be due to ischemia.
Hydrocephalus is an abnormal accumulation of excess cerebrospinal fluid (CSF) in the brain causing increased intracranial pressure, which can arise from a variety of causes, including congenital, acquired, or idiopathic pathologies. Ventriculoperitoneal (VP) shunting is most commonly used to treat hydrocephalic patients, relieving the increased intracranial pressure by draining excess CSF from the ventricles to the peritoneal cavity. VP shunts are primarily completed using either an open or a more minimally invasive neuronavigated laparoscopic-assisted surgical technique. There is a high level of surgical complications, shunt failures and revision rates following VP shunting. It is suggested that different surgical techniques are associated with varying degrees of patient outcomes, surgical complications, and revision rates, with the less invasive laparoscopic-assisted approach producing improved results. We present our results on 14 consecutive hydrocephalic patients, analyzed retrospectively between 2017 and 2019, investigating the benefits offered by the neuronavigated laparoscopic-assisted insertion of VP shunts. Additionally, we explain our workflow and procedural technique. By investigating these differences, changes can be implemented in current routine procedures to ameliorate patient safety, surgical complications, and revision rates.
Abstract. Intractable diplopia secondary to paralytic strabismus may be treated with the occlusion of the affected eye. Established treatments include occlusion with a patch, opaque spectacles or contact lenses, and perfoming upper lid lowering procedures or tarsorrhaphies. Two cases are presented in which intractable diplopia was resolved by performing clear lens phacoemulsification and the insertion of an opaque intraocular lens. Both patients reported a resolution of their diplopia having been dissatisfied with other forms of treatment. Although opaque intraocular lens insertion is not recommended as the initial treatment of choice in such cases, it offers a valuable treatment option for those patients in whom other forms of therapy have failed. [Ophthalmic Surg Lasers 2000;31:429-431]
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