By Lanning B. Kline, MD
Presents a symptom-driven method of the analysis and therapy of significant neuro-ophthalmic stipulations. With the point of interest at the sufferer, this booklet emphasizes exam and acceptable adjunctive stories, together with a dialogue of diagnostic imaging modalities, and leads the reader during the occasionally refined manifestations of neuro-ophthalmic affliction to anatomical localization of lesions and definitive analysis. an outline of the anatomy of visible pathways is followed by way of many illustrations. final significant revision 2009 2010.
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Extra info for 2011-2012 Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology (Basic & Clinical Science Course)
This section provides an overview of the ocular motor system, with a detailed discllssion of particularl y cl inicall y relevant structures. For interested readers, a comprehensive description of the ocu lar motor system can be found in the o utstanding textbook by Leigh and Zee (Leigh RJ. Zee OS. Th e Neurology of Eye Movements. 4th ed. ) To fa cilitate learning, the discussion is organized following a top-to-bottom approach: • cortical control of eye movements, including basal ganglion (BG), thalamus.
Target recognition and selection probably receive ad dit io nal input thro ugh the reciprocal con nections to the posterior parietal cortex (hum an homologue of area 73 in the rhesus mo nkey). Informati o n from the MT and MST projects via the posteri or portion of the internal capsule to the DLPN and lateral pontine nuclei, including the NRTP. From these pontine nuclei , projections are sent to the cerebellum (paraflocculus an d dorsal vermis), with outflow Signals to the vestibular nuclei and the y-g roup-a collection of cells at the inferior cerebellar peduncle (Fig 1-27).
To the cortical drainage, the superior sagittal sinus absorbs CSF through the arachnoid villi and the pacchionian gra nulation s. Thus, o bstru cti on to venous outflow res ults in decreased CSF absorpt ion and elevated intrac rania l pressure. The supe rior sagittal sinu s run s posteriorly to te rminate at th e torcular Herophili (confluence of the veno us sinu ses) at the level of the tentorium separa ting the cerebellum from the occipital lobes. The tral1sverse sinuses run anteriorly fro m th e connecti o n of th e te ntorium and the sku ll to the petrous pyramid, where they turn to run caudall y as the sigmoid sil1us down to the jugular bulb, where the il1ternal jugular vein ex its the skull.