By Lanning B. Kline, MD
Presents a symptom-driven method of the prognosis and remedy of significant neuro-ophthalmic stipulations. With the point of interest at the sufferer, this booklet emphasizes exam and applicable adjunctive reports, together with a dialogue of diagnostic imaging modalities, and leads the reader during the occasionally sophisticated manifestations of neuro-ophthalmic disorder to anatomical localization of lesions and definitive analysis. an outline of the anatomy of visible pathways is observed via many illustrations. final significant revision 2009 2010.
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Extra info for 2011-2012 Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology (Basic & Clinical Science Course)
The V5 area, whi ch corresponds to the med ial temporal visual region, receives ipsilatera l input from V I and direct input fro m the M-celliayers of the lateral ge ni culate. The neurons here encode the speed and d irection of mov ing stimuli. This sen sory area is li kely th e origin of pursuit move ments and thus links the affere nt and effe rent pathways. Compared with those of V I, the receptive fields are larger. tII1I(I. . t. . Occipitotemporal ~ "What" pathway Figure 1·22 Parallel visual processing pathways in the human.
Consisting of contra lateral 20 • Neuro-Opht halmo logy PCA AChA SCol RN CerePed / ON I ' ICA Chiasm Figure '·11 LGN \ Optic rad iation The relat ionship of the lateral geniculate nucleus to nearby structures and its blood supply. Key: AChA ~ anter ior choroidal artery, BC ~ brachium conjunctivum, CerePed ~ cerebral peduncles, ICA ~ internal carotid artery, LGN ~ lateral geniculate nucleus, MCA ~ middle cerebral artery, MGN:::: medial geniculate nucleus, ON = optic nerve, PCA = posterior cerebral artery, PCoA = posterior communi cating artery, PLChA = posterior lateral choroidal artery, Pulv = pulvinar, RN = red nucleu s, SeA = superior cerebellar artery, Seol collieulus.
Once it becomes intracra nial, the optic nerve no lo nger has a sheath . The an terior loop of the carotid artery usua ll y li es just below and temporal to the nerve, and the proximal ante rior cerebral artery passes over the nerve. The gy rus rectus, the most infe rior portion of the frontal lobe, lies above and parallel to the opti c nerves. The 8- 12 mm int racranial portion of the optic nerve terminates in the optic chiasm. Optic Chiasm The optic chias m measures approximately 12 mm wide, 8 mm long in the anteroposter ior direction, and 4 mm thick (Fig 1-19).