RESUMO
CASE REPORT: We present the case of a 29 year-old man who came to the Emergency Department due to pain in the right eye. There was demonstrated a complete corneal de-epithelialisation. There was no clinical improvement after appropriate treatment, which was complicated by migraine and vomiting. The computerized tomography (CT) scan showed images suggestive of cerebral toxoplasmosis. After the complete tarsorrhaphy a restitution ad integrum was observed. CONCLUSION: The diagnosis of a neurotrophic corneal ulcer due to an affected trigeminal nerve in the context of a cerebral toxoplasmosis, tarsorrhaphy is an effective procedure to take in account in corneal epithelial defects resistant to other treatments.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Úlcera da Córnea/etiologia , Pálpebras/cirurgia , Toxoplasmose Cerebral/complicações , Nervo Trigêmeo/fisiopatologia , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Cerebelo/diagnóstico por imagem , Cerebelo/parasitologia , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/parasitologia , Coccidiostáticos/administração & dosagem , Coccidiostáticos/uso terapêutico , Terapia Combinada , Úlcera da Córnea/tratamento farmacológico , Úlcera da Córnea/fisiopatologia , Úlcera da Córnea/cirurgia , Quimioterapia Combinada , Olho/inervação , Ganciclovir/administração & dosagem , Ganciclovir/uso terapêutico , Humanos , Masculino , Midriáticos/administração & dosagem , Midriáticos/uso terapêutico , Soluções Oftálmicas , Tomografia Computadorizada por Raios X , Toxoplasma/isolamento & purificação , Toxoplasmose Cerebral/diagnóstico por imagem , Toxoplasmose Cerebral/tratamento farmacológicoRESUMO
Caso clínico: Se presenta el caso de un varón 29 an os acude a Urgencias de oftalmología pordolor en ojo derecho. Se evidenció una desepitelizacion corneal completa. Tras un tratamientoadecuado no se evidenció mejoría clínica, complicándose el cuadro con cefalea yvómitos. la tomografía axial computarizada (TAC) evidenció imágenes sugestivas de toxoplasmosiscerebral. Tras la tarsorrafia completa se observó una restitución ad integrum delcuadro.Conclusión: Ante el diagnóstico de una úlcera corneal neurotrófica por afectación del trigéminoen el contexto de toxoplasmosis cerebral, la tarsorrafia es un procedimiento eficaz atener en cuenta ante defectos epiteliales corneales resistentes a otros tratamientos(AU)
Case report:We present the case of a 29 year-oldmanwhocame to the EmergencyDepartmentdue to pain in the right eye. Therewas demonstrated a complete corneal de-epithelialisation.There was no clinical improvement after appropriate treatment, which was complicated bymigraine and vomiting. The computerized tomography (CT) scan showed images suggestiveof cerebral toxoplasmosis. After the complete tarsorrhaphy a restitution ad integrum wasobserved.Conclusion: The diagnosis of a neurotrophic corneal ulcer due to an affected trigeminal nervein the context of a cerebral toxoplasmosis, tarsorrhaphy is an effective procedure to take inaccount in corneal epithelial defects resistant to other treatments(AU)
Assuntos
Humanos , Masculino , Adulto , Úlcera da Córnea/complicações , Infecções por HIV/complicações , /análise , Toxoplasmose Cerebral/complicaçõesRESUMO
CASE REPORT: A 20-year-old male, HIV positive, with myodesopsias (floaters) in both eyes for two weeks. Fundus examination revealed bilateral papillary oedema with peripapilar flame-shaped haemorrhages. The neuroimaging tests showed a cerebral mass in the left parietal lobe. The biopsy confirmed the diagnosis of lymphoid neoplasm. DISCUSSION: Primary lymphoma is the most common malignancy of the central nervous system (CNS) in AIDS patients, although highly active antiretroviral therapy has reduced its incidence. The ophthalmologist plays an essential role in the diagnosis of CNS neoplasm.
Assuntos
Neoplasias Encefálicas/diagnóstico , Linfoma/diagnóstico , Lobo Parietal , Neoplasias Encefálicas/complicações , Humanos , Linfoma/complicações , Masculino , Oftalmologia , Papiledema/etiologia , Adulto JovemRESUMO
Caso clínico: Paciente varón de 20 años, VIH positivo, con miodesopsias en ambos ojos de 2semanas de evolución. El examen fundoscópico reveló edema de papila bilateral con hemorragiasperipapilares en llama. El estudio de neuroimagen mostró la presencia de unamasa cerebral en el lóbulo parietal izquierdo. La biopsia confirmó el diagnóstico de neoplasiade estirpe linfoide.Discusión: El linfoma primario es la neoplasia más frecuente del sistema nervioso central(SNC) en pacientes con sida (síndrome de inmudeficiencia adquirida) aunque la terapiaantirretroviral de gran actividad ha disminuido su incidencia. Destacamos el papel del oftalmólogoen el diagnóstico de neoplasias del SNC(AU)
Case report: A 20-year-old male, HIV positive, with myodesopsias (floaters) in both eyes fortwo weeks. Fundus examination revealed bilateral papillary oedema with peripapilarflame-shaped haemorrhages. The neuroimaging tests showed a cerebral mass in the leftparietal lobe. The biopsy confirmed the diagnosis of lymphoid neoplasm.Discussion: Primary lymphoma is the most common malignancy of the central nervoussystem (CNS) in AIDS patients, although highly active antiretroviral therapy has reducedits incidence. The ophthalmologist plays an essential role in the diagnosis of CNSneoplasm(AU)
Assuntos
Humanos , Masculino , Adulto , Neoplasias Encefálicas/diagnóstico , Linfoma Relacionado a AIDS/diagnóstico , Papiledema/diagnóstico , Achados IncidentaisRESUMO
CASE REPORT: A 42-year-old man was diagnosed with band or "bow tie" optic atrophy with a right homonymous hemianopia. Computerized tomography (CT) revealed a calcified lesion in the left hippocampus. Craniotomy and tumor resection were performed. The biopsy revealed a subependymoma of the temporal horn of the left ventricular system. DISCUSSION: Optic tract lesions are uncommon clinical entities, in which homonymous hemianopia and contralateral band optic atrophy are characteristic. Subependymomas are infrequent and benign tumors that are typically associated with the ventricular system.
Assuntos
Neoplasias do Ventrículo Cerebral/complicações , Glioma Subependimal/complicações , Atrofia Óptica/etiologia , Adulto , Humanos , MasculinoRESUMO
Caso clínico: Varón de 42 años con atrofia óptica en banda o en «pajarita» derecha con hemianopsia homónima derecha. En la tomografía computerizada (TC) se observa una lesión calcificada a nivel de hipocampo izquierdo. Se realizó craneotomía y resección tumoral con diagnóstico definitivo de subependimoma de asta temporal de ventrículo lateral izquierdo. Discusión: Las lesiones de la cintilla óptica son entidades clínicas poco frecuentes que cursan con hemianopsia homónima y atrofia óptica en banda o en «pajarita» contralateral. El subependimoma es un tumor infrecuente y benigno, que se asocia típicamente con el sistema ventricular
Case report: A 42-year-old man was diagnosed with band or «bow tie» optic atrophy with a right homonymous hemianopia. Computerized tomography (CT) revealed a calcified lesion in the left hippocampus. Craniotomy and tumor resection were performed. The biopsy revealed a subependymoma of the temporal horn of the left ventricular system. Discussion: Optic tract lesions are uncommon clinical entities, in which homonymous hemianopia and contralateral band optic atrophy are characteristic. Subependymomas are infrequent and benign tumors that are typically associated with the ventricular system
