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An Approach to Pupillary Disorders
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Sarosh M. Katrak, Azad M. Irani
HS from postganglionic lesions can result from a variety of causes. They may occur at the level of the superior cervical ganglion, ICA, cavernous sinus and superior orbital fissure. Of clinical relevance is spontaneous or traumatic ICA dissection. This condition presents with unilateral head and/or neck pain, focal cerebral ischemic symptoms and a HS. Here, anhidrosis is restricted to the distribution of the first division of the trigeminal nerve as mentioned earlier. The rest of the face is spared because the sudomotor fibers travel along the external carotid artery which is not involved in the dissection. Thus, ICA dissection should be considered in any case with an acute-onset HS with pain in the neck and anhidrosis localized to the supraorbital area. HS, secondary to lesions of the superior cervical ganglion, are usually seen in trauma. Rarely HS may accompany oculomotor, first division of the trigeminal or abducens nerve palsy in cavernous sinus thrombosis or inflammation of the superior orbital fissure. Approximately two-thirds of cluster headaches may have postganglionic HS [12]. Raeder paratrigeminal neuralgia – a combination of unilateral headache, supraorbital pain and ipsilateral postganglionic HS – is a rare entity and is believed to be a variant of cluster headache [13].
The Pineal Gland and Melatonin
Published in George H. Gass, Harold M. Kaplan, Handbook of Endocrinology, 2020
Jerry Vriend, Nancy A.M. Alexiuk
There are many similarities between the effects of the pineal on the neuroendocrine-gonadal axis and the neuroendocrine-thyroid axis. The inhibitory effects of an active pineal gland, or of melatonin injections, on gonadal and thyroid axes occur simultaneously in the hamster under a variety of experimental conditions.389 These effects have a time course of 3 to 10 weeks depending on the experimental conditions. Pinealectomy prevents both the antithyroid and the antigonadal effects of light restriction (see above). Surgical removal of the superior cervical ganglia also prevents both the antithyroid and antigonadal effects of light restriction. Both the gonadal and thyroid axes respond similarly to melatonin administration. Because the antithyroid and antigonadal actions of an active pineal gland make use of the same neural pathways and occur simultaneously, they appear to be different aspects of a syndrome produced by melatonin at a single CNS site.389
The Autonomic Nervous System
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
Some preganglionic fibers arising from thoracolumbar sympathetic nuclei synapse with postganglionic fibers within the sympathetic trunks. These trunks are symmetrically located on each side of the vertebral column. They consist of 2 chains of interrelated paired ganglia, 3 cervical (termed superior, middle (inconstant), and inferior cervical ganglia), 11 to 12 thoracic (the first of which usually fuses with the inferior cervical ganglion to form the stellate ganglion), 3 to 4 lumbar, and 4 to 5 sacral ganglia. In the lower part of the spine, the sympathetic trunks from both sides progressively approach each other and fuse in a final unpaired ganglion, the coccygeal ganglion.
Hodgkin Lymphoma Associated Retinopathy: Report of a Case
Published in Ocular Immunology and Inflammation, 2022
Daphné Dedieu, Emna Bouayed, Antoine P. Brézin
Two months later, those manifestations became bilateral but continued to predominate in the right eye which had a BCVA decreased to 0.5. A systematic workup was performed. The full blood count, the angiotensin converting enzyme, the interferon gamma release assay were normal and the syphilis serology was negative. The cerebral spinal fluid analysis and the brain magnetic resonance imaging were normal. The chest CT-scan revealed a cervical lymph node with thymic infiltration and diaphragmatic lymph nodes. A cervical ganglion biopsy led to the diagnosis of a nodular sclerosis HL stage IIA (Reed Sternberg cells CD5+, CD30+, MUM1+). The patient was treated with a standard ABVD (Adriamycine, Bleomycine, Vinblastine, Dacarbazine) chemotherapy and oral prednisone. A complete remission was observed within six months. Follow-up ophthalmic visits showed a return to quiescence in both eyes. Four months after the onset of the treatment, a complete resolution of the anterior uveitis was observed while the white chorioretinal lesions evolved as pigmented scars predominating near the retinal vessels. The scarred chorioretinal lesions were hypoautofluorescent and the papillitis was replaced by peripapillary fibrosis with sub-retinal infiltrates (Figure 2).
Thyroid hormone levels and structural parameters of thyroid homeostasis are correlated with motor subtype and disease severity in euthyroid patients with Parkinson’s disease
Published in International Journal of Neuroscience, 2021
Yinyin Tan, Lei Gao, Qingqing Yin, Zhanfang Sun, Xiao Man, Yifeng Du, Yan Chen
In addition to the oxidative stress, as well as the TRH/thyrotropic and dopaminergic metabolism, sympathetic nervous denervation has also been involved in the PD pathogenesis and TH dysfunction. Decreased MIBG uptake of the thyroid has been first reported in PD in 2005. Sympathetic nervous denervation of PD occurs not only in the heart, but also in the thyroid [43]. It has been shown that, in the animal models, the bilateral surgical sympathectomy performed by removing superior cervical ganglia (SCG) could decrease the secretion of TH [44]. The sympathetic innervation of cephalic blood vessels, the pineal gland, choroid plexus, eyes, salivary and thyroid glands, and carotid body is provided by SCG [45]. There is Lewy pathology in SCG of PD patients [46]. However, the uptake of 123I-MIBG by the thyroid is reduced in PD patients. The a-synuclein can aggregate in the upper thoracic sympathetic ganglia and stellate, which may cause up-regulated uptake and down-regulated washout ratio of cardiac 123IMIBG of PD patients [47]. Therefore, fT3 reduce is induced by the postganglionic sympathetic dysfunction due to the aggregation of a-synuclein in SCG [17].
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
The sympathetic chain is formed by a set of cervical ganglia and small fibers, also referred as sympathetic trunk. Although the sympathetic chain has an anatomical variability [58], most commonly is formed by a superior, middle, and inferior ganglion, as well as a stellate and vertebral ganglions. Superior, middle, and inferior ganglion are located at the level of the third, fifth and seventh cervical vertebra, respectively, whereas stellate and vertebral ganglia are related to the seventh cervical or first thoracic vertebra. Non infrequently, inferior cervical and stellate ganglion are fused [58]. The course of the sympathetic chain is oblique upward and laterally, under the prevertebral fascia. Its major axis forms an angle with the midline ranging between 10 and 11.5 degrees, and the distance of the inferior and superior ganglion from the medial border of the longus colli muscle measures 12.4 mm and 17.2 mm, respectively, on average [59,60]. The superior cervical ganglion is located above the longus capitis muscle and, at the level of C4/C5 disc, the sympathetic trunk crosses the line between the longus colli and longus capitis muscle.