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Retrobulbar Optic Nerve Cysticercosis.

Narra R, Jukuri JN, Kamaraju SK - J Glob Infect Dis (2015 Jul-Sep)

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Katuri Medical College, Guntur, Andhra Pradesh, India.

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Direct ophthalmoscopic examination revealed features suggestive of left optic disk edema and congestion... The examination of the right eye was normal... Based on the above CT and MRI findings a possibility of cysticercosis was considered... However, the presence of scolex and another similar cystic lesion in temporalis muscle a diagnosis of cysticercosis was considered... The patient was treated conservatively without histologic confirmation, thereby avoiding a surgical procedure... The diagnosis of cysticercosis is based on clinical, serologic, and imaging findings... The clinical findings and serologic results may occasionally be nondiagnostic... Four stages are noted in the evolution of cysticercosis: Vesicular, colloidal vesicular, granular nodular, and the nodular calcified stage... Identification of the cyst and associated scolex is seen in the vesicular stage... The vesicular stage was probably present in our case; our imaging studies revealed a cyst with a mural nodule (scolex)... The optic nerve receives its blood supply from a branch of the central retinal artery a branch of ophthalmic artery... Hematogenous spread along the branches of this artery may result in isolated involvement of the optic nerve.

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Related in: MedlinePlus

Axial CT section in a 21-year-old patient at the level of optic nerve showing a cyst with mural nodule in the mid portion of left optic nerve (arrow). CT: Computed tomography
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Figure 1: Axial CT section in a 21-year-old patient at the level of optic nerve showing a cyst with mural nodule in the mid portion of left optic nerve (arrow). CT: Computed tomography

Mentions: Cysticercosis is the most common parasitic disease involving the central nervous system (CNS). It is caused by infestation of the larval form of Taenia solium, with humans being the primary host. Intraocular cysticercosis occurs in 3% of the cases. Optic nerve involvement by cysticercosis is extremely rare, with very few cases in the literature.[1] A 21-year-old man was referred to our department for computed tomography (CT). He complained of dull headache of the left frontal and temporal region and left ocular pain and mild left orbital swelling and small nodular swelling in left temporal region. The ocular pain was exacerbated with eye movement (ophthalmoplegia). The patient also noted a gradual progressive diminished vision in the left eye since 1 month. The patient had been treated at an outside hospital with painkillers and steroids, but had experienced no improvement in his symptoms. Direct ophthalmoscopic examination revealed features suggestive of left optic disk edema and congestion. The examination of the right eye was normal. Initial CT was performed in the axial plane with 5-mm contiguous sections followed by 1.25-mm sections. The study revealed an approximately 9-mm cyst located in the mid portion of the left optic nerve [Figures 1 and 2]. A magnetic resonance imaging (MRI) study revealed the lesion to have high T2 signal and to expand the mid portion of the optic nerve in a fusiform manner [Figure 3]. The T1-weighted sequence showed the lesion to be of low signal. The cystic lesion was causing expansion of the nerve with margins of the nerve clearly noted around the cyst. Another small cyst was noted in left temporalis muscle [Figure 4].


Retrobulbar Optic Nerve Cysticercosis.

Narra R, Jukuri JN, Kamaraju SK - J Glob Infect Dis (2015 Jul-Sep)

Axial CT section in a 21-year-old patient at the level of optic nerve showing a cyst with mural nodule in the mid portion of left optic nerve (arrow). CT: Computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4557144&req=5

Figure 1: Axial CT section in a 21-year-old patient at the level of optic nerve showing a cyst with mural nodule in the mid portion of left optic nerve (arrow). CT: Computed tomography
Mentions: Cysticercosis is the most common parasitic disease involving the central nervous system (CNS). It is caused by infestation of the larval form of Taenia solium, with humans being the primary host. Intraocular cysticercosis occurs in 3% of the cases. Optic nerve involvement by cysticercosis is extremely rare, with very few cases in the literature.[1] A 21-year-old man was referred to our department for computed tomography (CT). He complained of dull headache of the left frontal and temporal region and left ocular pain and mild left orbital swelling and small nodular swelling in left temporal region. The ocular pain was exacerbated with eye movement (ophthalmoplegia). The patient also noted a gradual progressive diminished vision in the left eye since 1 month. The patient had been treated at an outside hospital with painkillers and steroids, but had experienced no improvement in his symptoms. Direct ophthalmoscopic examination revealed features suggestive of left optic disk edema and congestion. The examination of the right eye was normal. Initial CT was performed in the axial plane with 5-mm contiguous sections followed by 1.25-mm sections. The study revealed an approximately 9-mm cyst located in the mid portion of the left optic nerve [Figures 1 and 2]. A magnetic resonance imaging (MRI) study revealed the lesion to have high T2 signal and to expand the mid portion of the optic nerve in a fusiform manner [Figure 3]. The T1-weighted sequence showed the lesion to be of low signal. The cystic lesion was causing expansion of the nerve with margins of the nerve clearly noted around the cyst. Another small cyst was noted in left temporalis muscle [Figure 4].

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Katuri Medical College, Guntur, Andhra Pradesh, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Direct ophthalmoscopic examination revealed features suggestive of left optic disk edema and congestion... The examination of the right eye was normal... Based on the above CT and MRI findings a possibility of cysticercosis was considered... However, the presence of scolex and another similar cystic lesion in temporalis muscle a diagnosis of cysticercosis was considered... The patient was treated conservatively without histologic confirmation, thereby avoiding a surgical procedure... The diagnosis of cysticercosis is based on clinical, serologic, and imaging findings... The clinical findings and serologic results may occasionally be nondiagnostic... Four stages are noted in the evolution of cysticercosis: Vesicular, colloidal vesicular, granular nodular, and the nodular calcified stage... Identification of the cyst and associated scolex is seen in the vesicular stage... The vesicular stage was probably present in our case; our imaging studies revealed a cyst with a mural nodule (scolex)... The optic nerve receives its blood supply from a branch of the central retinal artery a branch of ophthalmic artery... Hematogenous spread along the branches of this artery may result in isolated involvement of the optic nerve.

No MeSH data available.


Related in: MedlinePlus