Dr. Airy's "morbid affection of the eyesight": lessons from Teichopsia Circa 1870.

Hubert Airy's iconic drawing of his own migraine visual aura for which he coined the term, "teichopsia," conveys important lessons for the contemporary clinician. His observations of the expansion ("build-up"), minification/magnification, and color/achromatopsia of migrainous teichopsia are consistent with (and possibly anticipatory of) the later discoveries of cortical spreading depression, cortical magnification of primary visual cortex (V1), and specialized cortical centers for color vision.

The cerebral cortex of Albert Einstein: a description and preliminary analysis of unpublished photographs.

Upon his death in 1955, Albert Einstein's brain was removed, fixed and photographed from multiple angles. It was then sectioned into 240 blocks, and histological slides were prepared. At the time, a roadmap was drawn that illustrates the location within the brain of each block and its associated slides. Here we describe the external gross neuroanatomy of Einstein's entire cerebral cortex from 14 recently discovered photographs, most of which were taken from unconventional angles. Two of the photographs reveal sulcal patterns of the medial surfaces of the hemispheres, and another shows the neuroanatomy of the right (exposed) insula. Most of Einstein's sulci are identified, and sulcal patterns in various parts of the brain are compared with those of 85 human brains that have been described in the literature. To the extent currently possible, unusual features of Einstein's brain are tentatively interpreted in light of what is known about the evolution of higher cognitive processes in humans. As an aid to future investigators, these (and other) features are correlated with blocks on the roadmap (and therefore histological slides). Einstein's brain has an extraordinary prefrontal cortex, which may have contributed to the neurological substrates for some of his remarkable cognitive abilities. The primary somatosensory and motor cortices near the regions that typically represent face and tongue are greatly expanded in the left hemisphere. Einstein's parietal lobes are also unusual and may have provided some of the neurological underpinnings for his visuospatial and mathematical skills, as others have hypothesized. Einstein's brain has typical frontal and occipital shape asymmetries (petalias) and grossly asymmetrical inferior and superior parietal lobules. Contrary to the literature, Einstein's brain is not spherical, does not lack parietal opercula and has non-confluent Sylvian and inferior postcentral sulci.

False and non-localizing signs in neuro-ophthalmology.

The absolute reliance on abnormal neuro-ophthalmologic findings as signposts for particular lesions of the neuraxis must be tempered by a working knowledge of false and nonlocalizing signs and symptoms. Transient monocular visual loss or complex visual hallucinations may lead to neuroanatomic ambiguity, and elevated intracranial pressure is not the most common cause of swollen optic disks in late life. Sixth nerve palsy associated with increased intracranial pressure is possibly the best-known false localizing sign, but other ocular motility disturbances (divergence paresis, convergence insufficiency, and skew deviation) also elude localization. Lastly, the localizing pitfalls of anisocoria--Horner and Raeder syndromes, physiologic anisocoria, pupil-involving third nerve palsy, and benign pupillary dilation--are discussed.