Bankstown Hospital - Grand Rounds - Further Reading

Welcome to the Grand Rounds Further Reading List, Neurology edition, brought to you by the Clinical Library, on Level 4, next to the Auditorium.

This library guide is to help support you in your professional development. Please give us feedback so we can improve this bulletin in the future.

Some sections are under construction and will be ready later in the year. If you are presenting at a later Grand Rounds, please contact lynne.roberts3@health.nsw.gov.au and tell us about the content of your paper so we can add appropriate resources to the list for when you present your paper.

If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.au or visit us Monday to Fridays, 8.30am - 5.00pm.

'Unusual case of headache

and visual disturbance'.

Barral, E., et al. (2023). "Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome." Diagnostics 13(2): 252 https://www.mdpi.com/2075-4418/13/2/252 REQUEST ARTICLE

Migraine is a severe and common primary headache disorder, characterized by pain as well as a plethora of non-painful symptoms. Among these, visual phenomena have long been known to be associated with migraine, to the point where they can constitute a hallmark of the disease itself. In this review we focus on two key visual disorders that are directly or indirectly connected to migraine: visual aura and visual snow syndrome (VSS). Visual aura is characterized by the transient presence of positive and negative visual symptoms, before, during or outside of a migraine attack. VSS is a novel stand-alone phenomenon which has been shown to be comorbid with migraine. We discuss key clinical features of the two disorders, including pathophysiological mechanisms, their differential diagnoses and best treatment practices. Our aim is to provide an aid for clinicians and researchers in recognizing these common visual phenomena, which can even appear simultaneously in patients with an underlying migraine biology.

Binczyk, N. M., et al. (2022). "Visual Disturbances and Headache as Presenting Symptoms of Creutzfeldt–Jakob Disease." Journal of Neuro-Ophthalmology 42(2): e488-e490 https://journals.lww.com/jneuro-ophthalmology/fulltext/2022/06000/visual_disturbances_and_headache_as_presenting.34.aspx REQUEST ARTICLE

Creutzfeldt–Jakob disease (CJD) is a progressive neurodegenerative prion disease which presents clinically as a rapidly progressive dementia and is fatal within months. The Heidenhain variant of CJD (HvCJD) is rare and presents predominantly with visual symptoms such as decreased visual acuity, blurred vision, cortical visual field defects, dyschromatopsia, palinopsia, and other visual symptoms (¹). In this article, we present a case of rapidly progressive HvCJD which presented with unusual visual distortions and headache.

                Fan, J., et al. (2024). "Not just any headache." Survey of Ophthalmology 69(2): 287-290 https://www.sciencedirect.com/science/article/pii/S003962572300139X REQUEST ARTICLE

A 40-year-old man with a history of traumatic retinal detachment in the left eye treated with scleral buckle and migraine with aura presented to clinic for persistent blurry vision of the right eye following an episode of migraine with aura. The patient had experienced migraines with visual auras starting as a teenager, which normally resolve within an hour except for the most recent episode. Humphrey visual field showed a right superior homonymous quadrantanopia. Computed tomography of the head without contrast showed acute ischemia in the left occipital lobe. Magnetic resonance imaging of the brain confirmed an ischemic infarct of the left occipital lobe. There were no significant abnormalities in complete blood count, metabolic panel, coagulation studies, and infectious testing. Echocardiogram and transthoracic echocardiography were normal as well, but further work up by cardiology revealed a patent foramen ovale on transesophageal echocardiogram. This case illustrates a rare case of migrainous infarction, which should be considered as a possible complication of migraine with aura, presenting with persistent visual changes.

Marzoli, S. B. and A. Criscuoli (2015). "Headaches attributed to visual disturbances." Neurological Sciences 36(1): 85-88 https://doi.org/10.1007/s10072-015-2167-4

REQUEST ARTICLE

Ocular pain due to ophthalmological diseases is most commonly associated with redness and inflammation of the ocular surface and surrounding tissues. Pain in a quiet eye can be referred as headache and can be the first sign of a number of ocular or orbital conditions. Painful symptoms may be considered non-specific if signs of targeted diseases are not identified. Collection of appropriate history of pain around the eye and associated symptoms or signs should be considered to recognize when ophthalmological examination is needed. Some painful diseases such as intermittent angle closure glaucoma, uveitis or optic neuritis, can lead to severe and permanent visual loss and require a prompt diagnosis and treatment.