Q1- 7 years old boy-
present with head ache and repeated vomiting after FFH
CT-scan show no features of
brain edema, and treated conservatively
In the second day, the patient
had visual loss
Ophthamological examination
show:
No features of internal and
external ophthalmoplegia
Normal reacting pupil
Normal fundus
*What is the possible
cause of visual loss and why?
Most propably due ho cortical
blindness due to absence of internal and external ophthalmoplegia
*What is the
prognosis?
Good prognosis
It is transient visual loss
for few days
*What is the
treatment?
Treated conservatively
Q2-50 years old female
with head ache and visual disturbance for 20 days duration on gradual
progression and of subacute onset, head ache was diffuse, non throbbing,
persisted all over the time
The patient is poor controlled
diabetic on oral hypoglycemic agents
On examination
-General condition
No jaundice, no anemia, no
lymph node enlargement, good hydration
-cranial n.
No relevant find
No parietal lobe signs
No cerebellal signs
No meningeal signs
*What investigations
you need?
1-CT-scan
2-lumber puncture
The investigations show that
the patient had elevated I.C.P
Then, emergency lumber
peritoneal shunt done
Patient get better regarding
head ache and vision
3 months later, symptoms
recurrent and after few weeks visual deteriorations occur
On evaluation abdominal catheter
was disloged, reimplantation done, the patient also get better but still there
is some residual visual disturbance
*What is the
investigations we need:
1- lumber puncture
2- abdominal X-ray
The last investigations show
normal CSF pressure and normal catheter position
Then , the patient reffered to
ophthalmologist for ophthalmological evaluation
*What is the possible
ophthalmological causes in this case?
1- atrophic changes
2- diabetic retinopathy
*What is the
treatment?
Good blood sugar control
**special thanks to Dr. Saif Anmar (neurosurgeon,
M.B.CH.B. ,F.I.C.M.S.) for his great helpness in collect this cases and
presented it in this nice picture, from Ibn sina hospital