Document Detail

Bilateral optic nerve sheath enhancement from giant cell arteritis.
MedLine Citation:
PMID:  12610827     Owner:  NLM     Status:  MEDLINE    
An 83-year-old man presented with acute bilateral visual loss to no light perception (NLP) OD and 20/50 OS. His fundus examination showed moderate bilateral pallid disc edema. A sedimentation rate was 60 mm/h. Magnetic resonance imaging of the brain and orbits with gadolinium revealed marked bilateral enhancement of the optic nerve sheaths and adjacent orbital fat. He underwent biopsies of the optic sheath OD and bilateral temporal arteries. Histopathology of the optic nerve sheath area revealed fibroadipose tissue containing numerous arteries with intimal thickening, and mild mural inflammation consisting predominantly of lymphocyte with occasional giant cells. The bilateral temporal artery biopsies revealed focal disruption of the elastic lamina with rare giant cells. His vision had since stabilized on IV methypdnisolone therapy. The biopsies of the nerve sheath suggest that the radiologic finding of optic nerve sheath enhancement in giant cell arteritis is caused by tbe same pathophysiology, and therefore may be a manifestation of this systemic disease.
Kenneth E Morgenstern; Brian D Ellis; Sidney S Schochet; John V Linberg
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  30     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-28     Completed Date:  2003-06-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  625-7     Citation Subset:  IM    
Department of Ophthalmology and Neuropathology, West Virginia University Hospitals, Morgantown, West Virginia 26506, USA.
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MeSH Terms
Aged, 80 and over
Giant Cell Arteritis / complications*,  pathology
Magnetic Resonance Imaging
Optic Neuropathy, Ischemic / etiology*,  pathology
Vision Disorders / etiology*,  pathology

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