BACKGROUND Various types of lumbar dural punctures may contribute to neurological injury. The etiologies of dural injury include; inadvertent dural punctures due to epidurals placed for labor anesthesia, epidural steroid injections (ESI/transforaminal TESI; approximately 9 million ESI performed in the US per year), deliberate placement of intradural pain devices, and spontaneous cerebrospinal f...

PURPOSE To report a case of third, fourth, and six cranial nerve palsies with antiphospholipid syndrome (APS). METHODS Medical records of a 16-year-old female diagnosed with idiopathic intracranial hypertension (IIH) in primary APS were reviewed. RESULTS A 16-year-old female presented with headache and diplopia. Ocular examinations revealed marked bilateral disc edema. She was unable to dep...

Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. Howev...

We report a case of a 50-year-old female with diabetes mellitus who presented with progressive second, third, fifth, sixth, and eighth cranial nerve palsy. Diagnostic investigation revealed hyperglycemic state, and brain imaging showed a right cavernous sinus enhancement suggestive of and consistent with Tolosa-Hunt syndrome. The patient was started on steroids with tight glycemic control for e...

Two patients with mild, adult-onset diabetes mellitus developed a painful ophthalmoplegia and ipsilateral optic neuropathy that was relatively unresponsive to steroids. Histopathological study of the optic nerve of one patient revealed an extensive ischaemic infarct. There was ultimate recovery from the cranial nerve palsies in both patients and the optic neuropathy in one patient. Ischaemic po...

CLINICAL FEATURES The presentation of CVT can be acute, subacute or chronic. The presenting symptoms are grouped into four major syndromes (Bousser et al. 1997): • isolated intracranial hypertension – headache, visual obscurations, vomiting, papilloedema ± sixth nerve palsy (Biousse et al. 1999); • focal syndrome – focal or generalized seizure and/or a focal defi cit such as monoor hemi-paresis...

Objective The clinical presentation of sphenoid sinusitis can be highly variable. Rarely, sphenoid sinusitis may present with cranial nerve complications due to the proximity of these structures to the sphenoid sinus. Method A case series from Rabin Medical Center and all cases of cranial nerves palsies secondary to sphenoid sinusitis that have been reported in the literature were reviewed. ...

Background: Microvascular ocular cranial nerve palsy can result from diabetes and hypertension and may be increasing with the increase in the incidence of diabetes and hypertension in Nigeria. Objective: This study provides clinical considerations for the neuro-ophthalmic evaluation of diplopic patients with presumed microvascular ocular cranial nerve palsy. Method: A case report is presented o...

PURPOSE OF REVIEW Determining which cranial nerve(s) is (are) involved is a critical step in appropriately evaluating a patient with diplopia. RECENT FINDINGS New studies have looked at the various etiologies of cranial nerve palsies in the modern imaging era. The importance of the C-reactive protein test in evaluating the possibility of giant cell arteritis has recently been emphasized. SU...