Obstructive sleep apnea in those with idiopathic intracranial hypertension undergoing diagnostic in-laboratory polysomnography.

Rationale: The association of obstructive sleep apnea (OSA) with idiopathic intracranial hypertension (IIH) remains unclear, and few studies have used objective in-laboratory polysomnography (PSG) data. Thus, we used PSG data to examine the: 1) association between OSA, and its severity, with IIH and 2) sex differences in OSA severity in those with and without IIH.

Methods: We retrospectively analyzed diagnostic PSG data from January 2015 to August 2023 for patients who were diagnosed with IIH by a neuro-ophthalmologist using the modified Dandy criteria.

Abducens Nerve Palsy as a Presenting Symptom of Multiple Sclerosis.

Multiple sclerosis (MS) is a chronic disorder characterized by demyelination of the central nervous system. It often presents in women aged 18-35 with neurological symptoms such as visual loss, paresthesia, focal weakness, and ataxia. Demyelination in the brainstem can result in internuclear ophthalmoplegia causing binocular horizontal diplopia.

Neurovascular Compression in the Anterior Visual Pathway: A Case Series.

A retrospective review of 29 patients with neurovascular compression syndrome (NVCS) involving the anterior visual pathway was conducted. Various patterns of NVCS and visual defects were identified, most commonly involving the optic nerve and internal carotid artery. Most patients were stable, except one with progressive visual field defects.

Idiopathic Intracranial Hypertension: A Case Study of Patient Engagement in the Treatment of a Chronic Disease.

Idiopathic intracranial hypertension is a rare neurological disorder characterized by increased intracranial pressure, which can lead to visual loss and headaches. While medical therapy exists, weight loss is the only disease-modifying treatment. Weight loss is the only therapy that leads to sustained resolution of papilledema.

SLEAP SMART (Sleep Apnea Screening Using Mobile Ambulatory Recorders After TIA/Stroke): A Randomized Controlled Trial.

Background And Purpose: Poststroke/transient ischemic attack obstructive sleep apnea (OSA) is prevalent, linked with numerous unfavorable health consequences, but remains underdiagnosed. Reasons include patient inconvenience and costs associated with use of in-laboratory polysomnography (iPSG), the current standard tool. Fortunately, home sleep apnea testing (HSAT) can accurately diagnose OSA and is potentially more convenient and cost-effective compared with iPSG.

Unilateral Papilledema in Idiopathic Intracranial Hypertension: A Case Series.

Idiopathic intracranial hypertension (IIH) typically presents with bilateral papilledema; however, highly asymmetric and rare unilateral cases have been reported. We report three cases of IIH meeting modified Dandy criteria presenting with unilateral papilledema. Magnetic resonance imaging (MRI) demonstrated bilateral distention of the optic nerve sheaths and computed tomography (CT) of the orbits demonstrated a smaller diameter of the optic canal in the unaffected eye in two cases.

Congenital Herniation of the Gyrus Rectus Resulting in Compressive Optic Neuropathy.

We report a 34-year-old male with a previously uninvestigated lifelong blindness of the right eye from compressive optic neuropathy secondary to congenital herniation of the gyrus rectus (HGR). His past medical history was otherwise unremarkable, with no history of prior head or ocular trauma. On examination, he had no light perception in the right eye, right relative afferent pupillary defect (RAPD), and primary optic atrophy.

Homonymous Retinal Ganglion Cell Layer Atrophy With Asymptomatic Optic Tract Glioma in Neurofibromatosis Type I.

Approximately 20% of patients with Neurofibromatosis type 1 (NF1) develop optic pathway gliomas (OPGs). Not all OPGs in NF1 necessarily become vision compromising and predicting which patients might develop visual decline is difficult at present time. Optical coherence tomography (OCT) has emerged as a useful tool able to directly assess the morphology and thickness of individual retinal layers.

An evaluation of genetic causes and environmental risks for bilateral optic atrophy.

Purpose: To assess the clinical utility of next-generation sequencing (NGS) for the diagnosis of patients with optic atrophy (OA).

Design: Retrospective cohort study.

Methods: 97 patients were referred to the McMaster University Medical Center (Hamilton, Ontario) for evaluation of bilateral OA.

Silent Post Cataract Bilateral Sequential Nonarteritic Anterior Ischaemic Optic Neuropathy.

Nonarteritic anterior ischaemic optic neuropathy (NAION) has been reported as a rare occurrence following cataract surgery. Bilateral sequential NAION following cataract surgery is extremely rare. We report an 83-year-old male who developed bilateral sequential NAION within 5 and 3 weeks of undergoing uneventful cataract surgeries in each eye.

Cortical Ribbon Sign in Acute Hepatic Encephalopathy with Sequential Atrophy.

A 59-year-old man presented with confusion, decreased level of consciousness, and generalized tonic-clonic seizures. He was intubated and promptly stabilized on antiepileptic medications. He was not in status epilepticus.

Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature.

Purpose: Radiation-induced pseudoprogression is a subacute clinical entity that is distinct from radiation necrosis and mimics tumor progression. Bevacizumab is a well-described treatment option for radiation necrosis, but its role in pseudoprogression is not clearly defined.

Methods: We report a case of radiation-induced pseudoprogression rescued with bevacizumab in a 20-year-old man with a biopsy-proven low-grade astrocytoma of the tectum.

Neural network and logistic regression diagnostic prediction models for giant cell arteritis: development and validation.

Purpose: To develop and validate neural network (NN) vs logistic regression (LR) diagnostic prediction models in patients with suspected giant cell arteritis (GCA). Design: Multicenter retrospective chart review.

Methods: An audit of consecutive patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at 14 international medical centers.

Optic nerve sheath meningocele.

Optic nerve sheath meningocele, also called dural ectasia of the optic nerve, is a benign dilation of the optic nerve sheath. We report two interesting cases of primary optic nerve sheath meningocele. Etiology, clinical features, and management options are discussed.