Jorge Burneo de las Casas⁽¹⁾, Andrew Chang^(2)
(1)Henry Ford Health System - detroit. United States
⁽²⁾Affiliated Comm. Medical Center - Willmar. United States

		[Radiology & Nuclear Medicine]
	[Neurology]

DISCUSSION

The pathophysiology of SSN remains unclear. Its association with bitemporal homonymous hemianopsia in patients with parasellar and chiasmal lesions initially led to the speculation that SSN was related to a disturbance in the visual input. Subsequent reports of SSN in patients with chiasmal and brainstem lesions in the absence of significant visual deficits made the previous concept not true. ^(4,6).

The instertitial nucleus of Cajal (INC), adjacent to the medial longitudinal fasciculus in the midbrain tegmentum, has been frequently implicated in the pathogenesis of SSN. Fibers from the INC project to the oculomotor and trochlear nerves, vestibular nuclei and spinal cord. A disturbance in the INC itself or in its projections may contribute to the mechanism underlying SSN.⁽⁴⁾.

With SSN ocurring in association with NS as seen in our patient, we postulate that granulomatous inflammation of the INC and/or in the accesory optic tract, a pathway of nerve fibers traversing the optic chiasm and the inferior olivary nucleus, may play a significant role in the development of SSN. Hydrocephalus alone has not been reported with SSN.

Discussion Board

Any Comment to this presentation?

[ABSTRACT] [INTRODUCTION] [CASE] [IMAGES] [DISCUSSION] [CONCLUSION] [BIBLIOGRAPHY] [Discussion Board]

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		[Radiology & Nuclear Medicine]
	[Neurology]

Jorge Burneo de las Casas, Andrew Chang
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Last update: 10/01/00