دورية أكاديمية
Cavernous Sinus MRI Findings in Inflammatory and Ischemic Oculomotor Cranial Nerve Palsies.
| العنوان: | Cavernous Sinus MRI Findings in Inflammatory and Ischemic Oculomotor Cranial Nerve Palsies. |
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| المؤلفون: | Yunqing W; Departments of Neurology (WY, CS, SX, WJ) and Radiology (LQ), Beijing Tongren Hospital, Capital Medical University, Beijing, China; and Department of Radiology (LY), Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing, China., Shilei C, Yong L, Qing L, Xiaohong S, Jiawei W |
| المصدر: | Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society [J Neuroophthalmol] 2024 Jun 01; Vol. 44 (2), pp. 236-241. Date of Electronic Publication: 2023 Sep 25. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9431308 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-5166 (Electronic) Linking ISSN: 10708022 NLM ISO Abbreviation: J Neuroophthalmol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <1999->: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: New York, NY : Raven Press, c1994- |
| مواضيع طبية MeSH: | Cavernous Sinus*/diagnostic imaging , Cavernous Sinus*/pathology , Magnetic Resonance Imaging*/methods , Oculomotor Nerve Diseases*/diagnosis , Oculomotor Nerve Diseases*/diagnostic imaging, Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Aged ; Young Adult ; Adolescent ; Oculomotor Nerve/diagnostic imaging ; Oculomotor Nerve/pathology ; Aged, 80 and over ; Diagnosis, Differential ; Ischemia/diagnostic imaging ; Ischemia/diagnosis ; Child |
| مستخلص: | Background: The significance of asymmetric enhancement on cavernous sinus MRIs in the differential diagnosis of ischemic and inflammatory oculomotor cranial nerve (OCN) palsies remains controversial. This study explored the cavernous sinus MRI findings for cavernous sinus idiopathic inflammation (inflammation group), microvascular ischemic OCN palsy (ischemic group), and ocular myasthenia gravis (OMG group) patients. Methods: A total of 66, 117, and 60 patients were included in the inflammation, ischemic, and OMG groups, respectively. Cavernous sinus MRIs were retrospectively analyzed. Results: The abnormality rates of cavernous sinus MRIs for OMG and ischemic groups were 41.7% (25/60) and 61.5% (72/117), respectively. Inconsistency rates between clinical topical diagnosis and imaging findings for inflammation and ischemic groups were 3.0% (2/66) and 13.7% (16/117), respectively ( P = 0.020). In the inflammation group, cavernous sinus thickness, thickening enhancement, and enhancing adjacent lesions were noted in 90.9% (60/66), 71.2% (47/66), and 25.8% (17/66) of the patients, whereas in the ischemic group, they were noted in 51.3% (60/117), 38.5% (45/117), and 0.9% (3/117) of the patients, respectively ( P < 0.001). Among ischemic CN III palsy patients, 55.5% (15/27) and 16.7% (2/12) of the cases had CN III enlargement and enhancement in the diabetic and nondiabetic groups, respectively ( P = 0.037). Conclusions: Cavernous sinus MRI abnormalities can be explained by specific pathologic mechanisms of the primary disease based on the complex neuroanatomy. However, suspicious inflammatory changes cannot exclude the possibility of ischemia and over reliance on these findings should be avoided. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the North American Neuro-Ophthalmology Society.) |
| References: | Yang Y, Lai C, Yan F, Wang J. Clinical significance of MRI contrast enhancement of the oculomotor nerve in ischemic isolated oculomotor nerve palsy. J Clin Neurol. 2020;16:653–658. Chou KL, Galetta SL, Liu GT, et al. Acute ocular motor mononeuropathies: prospective study of the roles of neuroimaging and clinical assessment. J Neurol Sci. 2004;219:35–39. Nazerian P, Vanni S, Tarocchi C, et al. Causes of diplopia in the emergency department: diagnostic accuracy of clinical assessment and of head computed tomography. Eur J Emerg Med. 2014;21:118–124. Danieli L, Montali M, Remonda L, Killer HE, Colosimo C, Cianfoni A. Clinically directed neuroimaging of ophthalmoplegia. Clin Neuroradiol. 2018;28:3–16. Weidauer S, Hofmann C, Wagner M, Hattingen E. Neuroradiological and clinical features in ophthalmoplegia. Neuroradiology. 2019;61:365–387. Cerulli Irelli E, Di Pietro G, Fisco G, et al. Acute‐onset binocular diplopia in neurological unit: aetiological factors and diagnostic assessment. Acta Neurol Scand. 2021;144:92–98. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia, 2018;38:1–211. Zhao J, Li Y, Chang Q, Wang J, Sun H. Diabetic oculomotor nerve palsy displaying enhancement of the oculomotor nerve in the orbit and cavernous sinus on MRI. Eur Neurol. 2021;84:246–253. Majumdar J, Mukhopadhyay S, Sharan A, Sengupta S, Ghosh B. Tolosa-Hunt syndrome and ocular myasthenia: a rare coexistence or real association. J Assoc Physicians India. 2017;65:82–84. Li L, Wang Z, Lu MO. Tolosa-Hunt syndrome with general myasthenia gravis involvement. J Integr Neurosci. 2020;19:355–357. Frohman TC, Galetta S, Fox R, et al. Pearls & Oy-sters: the medial longitudinal fasciculus in ocular motor physiology. Neurology. 2008;70:e57–e67. Mullen E, Rutland JW, Green MW, Bederson J, Shrivastava R. Reappraising the Tolosa‐Hunt syndrome diagnostic criteria: a case series. Headache. 2020;60:259–264. Reinhold AK, Rittner HL. Characteristics of the nerve barrier and the blood dorsal root ganglion barrier in health and disease. Exp Neurol. 2020;327:113244. Richner M, Ferreira N, Dudele A, Jensen TS, Vaegter CB, Gonçalves NP. Functional and structural changes of the blood-nerve-barrier in diabetic neuropathy. Front Neurosci. 2018;12:1038. Mullen E, Green M, Hersh E, Iloreta AM, Bederson J, Shrivastava R. Tolosa-Hunt Syndrome: appraising the ICHD-3 beta diagnostic criteria. Cephalalgia. 2018;38:1696–1700. Hung CH, Chang KH, Wu YM, et al. A comparison of benign and inflammatory manifestations of Tolosa-Hunt syndrome. Cephalalgia. 2013;33:842–852. Li Y, Lip G, Chong V, Yuan J, Ding Z. Idiopathic orbital inflammation syndrome with retro-orbital involvement: a retrospective study of eight patients. PLoS One. 2013;8:e57126. Shuey NH. Ocular myasthenia gravis: a review and practical guide for clinicians. Clin Exp Optom. 2022;105:205–213. Murchison AP, Gilbert ME, Savino PJ. Neuroimaging and acute ocular motor mononeuropathies: a prospective study. Arch Ophthalmol. 2011;129:301–305. Ruff MW, Carabenciov ID, Johnson DR, Pollock B, Parisi J, Klaas J. A cavernous sinus lesion clinically responsive to steroids. J Clin Neurosci. 2018;53:239–240. |
| تواريخ الأحداث: | Date Created: 20230926 Date Completed: 20240514 Latest Revision: 20240805 |
| رمز التحديث: | 20240805 |
| مُعرف محوري في PubMed: | PMC11081484 |
| DOI: | 10.1097/WNO.0000000000001958 |
| PMID: | 37751328 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1536-5166 |
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| DOI: | 10.1097/WNO.0000000000001958 |