Lakshmi Leishangthem

University of Connecticut | UConn · Department of Neurology and Ophthalmology

In medically refractory idiopathic intracranial hypertension, optic nerve sheath fenestration or CSF shunting is considered the next line of management. Venous sinus stenosis has been increasingly recognized as a treatable cause of elevated intracranial pressure in a subset of patients. In this article, we present the results of the largest meta-an...

Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We...

Purpose of review: Negative findings on neuroimaging are part of the diagnostic criteria for idiopathic intracranial hypertension (IIH), a syndrome characterized by increased intracranial pressure (ICP). Some positive neuroimaging findings are associated with increased ICP, but their role in diagnosis of IIH has not been established. We provide an...

Pregnancy-associated meningiomas have unique considerations and features regarding their pathophysiology, location, genetic profile, and neurosurgical management. These tumours have been reported to undergo rapid growth during gestation and regression post-partum, implicating a role for female sex hormones in tumour physiology. In addition, these t...

An early adolescent female presented with blurry vision, ocular ‘fullness’, pulsatile tinnitus and gait difficulty due to poor vision. She was found to have florid grade V papilloedema, 2 months after the use of minocycline for the treatment of confluent and reticulated papillomatosis for 2 months. MRI of the brain without contrast showed fullness...

https://www.medlink.com/articles/alexia-without-agraphia

https://www.medlink.com/articles/combined-third-fourth-and-sixth-nerve-palsies

Visual snow syndrome (VSS) is a clinical disorder characterized by pan-field visual disturbance. It is a diagnosis of exclusion since its pathophysiology remains unknown. Excluding other mimics is of great significance since some serious pathologies can have secondary visual snow (VS) as an initial presentation. Delayed or incorrect diagnosis of th...

A man in his early 20s with cutaneous albinism was referred to an ophthalmologist for evaluation of nystagmus and photophobia. He denied oscillopsia. His best-corrected visual acuity was 20/80 OU. An anterior segment examination revealed iris transillumination defects in both eyes. Both of his fundi showed pronounced hypopigmentation of retinal pig...

Iris heterochromia is typically seen in association with congenital Horner syndrome. A man in his 40s with congenital iris heterochromia, blue in the right and brown in the left, presented with left-sided Horner syndrome. This was associated with recent change in color of his brown left iris to blue similar to the right iris. This case demonstrates...

A 70-year-old woman presented with new onset of left eye and facial pain. Ophthalmic and neurological examinations, MRI brain, ESR and CRP were unrevealing. A few days later she developed vision loss in her left eye. Exam revealed decreased visual acuity with a relative afferent pupillary defect in the left eye, and a diffuse mild swelling of the l...

Nephrotic syndrome is a hypercoagulable state and an uncommon cause of ischemic stroke in young patients. It is easily missed, although a simple uri-nalysis can point a clinician to this etiology. We present two cases of young males with recurrent stroke in which extensive workup for stroke etiology was initially done, followed by workup for protei...

BACKGROUND: Dural venous sinus stenting (DVSS) is an accepted treatment option in selected patients with medically refractory idiopathic intracranial hypertension and obstructive venous outflow physiology prior to cerebrospinal flow diversion (CSFD) surgery. There are no randomized controlled studies focusing on outcomes and complication rates for...

Objective: Minimize misdiagnosis of an anterior spinal artery aneurysm by reviewing presentation and present treatment options. Background: Anterior Spinal Artery aneurysms are rare and difficult to identify. To date, there are less than 30 published cases. Due to their size and relationship to the anterior spinal artery and spinal cord treatment...

Objective: MRSA is common after a neurosurgical procedure, although infective vasculitis and stroke are uncommon complications. Background: Post-operative dural leakage after trans-sphenoidal surgery is a known risk factor for meningitis, the incidence of this serious complication varies from 0.5–9%. Meningitis is not typically associated with vas...

Introduction: Dural Venous Sinus Stenting (DVSS) is increasingly being performed in select patients with medically refractory IIH. Criteria for stenting include: Patients who are medically refractive, obstructive venous outflow pattern on MRV and a significant pressure gradient across stenosis (>8 mm Hg) measured directly during venography. We...

71-year-old woman with progressive left-sided, monocular diplopia and ptosis. Her symptoms mimicked ocular myasthenia, but she had an indirect carotid cavernous fistula (CCF). She was diagnosed with monocular myasthenia gravis (negative acetylcholinesterase antibody) after a positive ice test and started on Mestinon and underwent a thymectomy compl...

Stent retrievers are FDA-approved devices specifically designed for mechanical thrombectomy in patients with acute ischemic stroke. We present a rare complication of intracranial hemorrhage secondary to vascular trauma caused during withdrawal of a stent retriever device, Trevo ProVue (Stryker Neurovascular). The risk of endovascular trauma during...

Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-c...

We present here an interesting case of a 61-year-old lady with multiple autoimmune disorders including SLE for 20 years, presenting with myelitis, without any visual involvement. Myelitis is a recognized accompaniment of SLE, and may even be the presenting manifestation. The recognition of NMO was pivotal in this case as it allowed utilizing treatm...

The authors report a case of an intracranial extravasation during the withdrawal of a Trevo ProVue stent retriever device in a patient being treated for acute ischemic stroke. An 82-year-old woman developed sudden left hemiparesis and aphasia during an urgent cardiac catheterization procedure for a non-ST elevation myocardial infarction. She had a...

A retrospective study of 113 patients was done to study presentation & visual outcome of penetrating ocular injuries. Visual acuity, wound size, uveal tissue prolapse, hyphema, traumatic cataract at presentation, presence of Intra ocular foreign body (IOFB), zone of injury, time elapse of repair were correlated with final visual acuity at 4 months...