26. Chiasm disorders

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  1. What is a prefixed, normal, postfixed chiasm?
    • prefixed: chiasm is BEFORE pituitary gland-15%- OT first
    • normal: 80%- chiasm first
    • postfixed: chiasm is AFTER pituitary gland- 5%- ON first
  2. Signs and symptoms of chiasmal lesions?
    • HA
    • diplopia
    • vision loss
    • VF BITEMPORAL HEMIANOPIA- vert midline
    • ON: bowtie
  3. Cushing's?
    • high levels of cortisol- pituitary adenoma
    • moonface, cns, hirutism, hypertension, diabetes
    • obesity, skin striae, bruising, muscle weakness, osteoperosis, ankle edema
  4. Acromegaly?
    • pituitary adenoma- excess growth hormone
    • facial coarseness, organomegaly, enlarged jaw
    • hypertension, diabetes, arthritis
    • carpal tunnel, cardiomyopathy
  5. Graves?
    • autoimmune, TED, hyperthyroidism- 
    • Caused by autoantibodies binding to and stimulating TSH-R=more T3 and T4
    • F, 30-40
  6. Signs of Graves?
    • exophthalmos
    • fatigue
    • weightloss
    • rapid heartbeat
    • muscular weakness
    • enlarged thryoid gland
  7. TED?
    • seen in Grave's
    • proptosis, enlarged EOM, corneal exposure, lid retraction and lag
    • ON compression: decreased CV, slow VA, central scotoma, optic atrophy
    • tx: steroids, smoking, lubricants, botox
  8. Chiasmal compression?
    • loss of nasal and papillomacular RNFL= bowtie atrophy
    • sup/inf OD ok
  9. Craniopharygioma?
    compresses OC
  10. tumour pressing on anterior chiasm?
    • nasal: temporal VF
    • inferior: superior VF
  11. Tumour pressing on superior chiasm?
    • nasal: bitemporal hemianopia VF
    • superior: affects more inferior
  12. Tuberculum sellae meningioma
    • older menopausal women
    • junctional scotoma
  13. Prosopagnosia?
    • disorder of face perception/recognition
    • Lesions occur in: fusiform gyrus, occipital lobe or temporal cortex
    • mainly in the right hemisphere: plays greater role in facial processing
    • VF results: left homonymous hemianopia
    • also achromatopsia
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26. Chiasm disorders
2013-11-13 10:46:01
Chiasm disorders

Chiasm disorders
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