RESUMEN
BACKGROUND: A porencephalic cyst is a cavity within the cerebral hemisphere, filled with cerebrospinal fluid, that communicates directly with the ventricular system. It is a rare condition probably caused by vascular occlusion resulting from an insult during fetal development or an injury occurring later in life. Porencephaly is often associated with various ophthalmic and neurologic signs, including visual-field defects, abnormal pupillary responses, optic nerve hypoplasia, decreased vision, nystagmus, strabismus, hemi-inattention, seizures, and mental deficiencies. CASE REPORTS: Two cases are presented of patients in whom porencephalic cysts developed as a result of traumatic head injuries. Both had demonstrable visual-field defects, with diagnosis of porencephaly verified by computed tomography scans of the head. CONCLUSIONS: Visual-field defects resulting from porencephalic cysts can mimic those observed with strokes or brain tumors. A thorough case history and complete neurologic workup can assist with differential diagnosis. The clinical features of porencephaly, different theories of brain recovery after trauma, and treatment options are discussed.
Asunto(s)
Encefalopatías/etiología , Lesiones Encefálicas/complicaciones , Quistes/etiología , Trastornos de la Visión/etiología , Adulto , Encefalopatías/diagnóstico por imagen , Encefalopatías/fisiopatología , Lesiones Encefálicas/diagnóstico por imagen , Quistes/diagnóstico por imagen , Quistes/fisiopatología , Estudios de Seguimiento , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/fisiopatología , Agudeza Visual/fisiología , Campos Visuales/fisiologíaRESUMEN
BACKGROUND: Prior to the advent of anti-tuberculosis medications, ocular manifestations of tuberculosis, including choroidal tubercles, were common. METHODS: A 46-year-old Hispanic male with a history of AIDS, tuberculosis and treated neurosyphilis presented for examination complaining of decreased vision in the left eye. Ophthalmoscopy revealed a large, elevated, juxtapapillary lesion consistent with a choroidal tubercle or an intraocular lymphoma. RESULTS: During follow-up, the lesion responded well to systemic anti-tuberculosis therapy. CONCLUSIONS: With the recent increase in incidence of tuberculosis in both th general population and AIDS patients, ocular manifestations of tuberculosis once thought to be rare may be increasing. Ocular tuberculosis should be considered in the differential diagnosis of patients presenting with intraocular masses, especially in individuals at high risk for exposure.