In 1911, neurologist Robert Foster-Kennedy, through analysis of medical records, revealed a previously undescribed syndrome. Its essence was the progressive degradation of the nerve and the decrease in visual acuity of the first eyeball with the parallel development of disk stagnation of the nerve in the second.
Causes of pathology
Foster Kennedy Syndrome can be triggered by the following conditions:
- neoplasms or purulent inflammation of the brain;
- protrusion of the wall of the arteries of the brain;
- inflammatory process of the meninges;
- TBI open or closed type;
- cerebral echinococcosis;
- aortic sclerosis.
In addition to the above cases, pathology can occur under the influence of diseases of the orbit:
- arachnoidendothelioma, which grows into the skull through the upper gap;
- retrobulbar gum associated with luetic meningitis.
The disease can be triggered by catastrophic changes in the brain in any area (occipital, temporal, frontal or parietal) as a symptom in the neighborhood or a symptom in the distance. The latter term means a brain displacement under the influence of a neoplasm or through an expanded ventricular system.
Disease mechanism
Foster-Kennedy syndrome is characterized by initial compression of the intracranial region of the optic nerve. As a result of this, ordinary atrophy is formed. If the pathology progresses, the pressure inside the cranium increases. In turn, this provokes nipple congestion in the other eye. However, a similar phenomenon does not develop on the initially affected eye due to atrophy of the optic canal.
An eye that has been depleted is often prone to the formation of a central scotoma on it, which depends on a drop in the quality of blood supply to the papillomacular bundle in the intracranial region of the optic nerve.
The congestion of the nipple of the other eye can be triggered not only by a pressure surge upward inside the cranium, but also by the influence of the main pathology on the intracranial section of the second optic nerve - chiasm. Therefore, with Foster-Kennedy syndrome, neurology distinguishes simple and complicated nipple congestion. Complication is characterized by a narrowing of the field of view.
Stages
The course of the pathology goes through the following stages:
- On one eyeball, a central scotoma is diagnosed, the bottom without anomalies. The second eye has nipple congestion.
- Optic depletion of the optic nerve is added to the central scotoma of one eyeball. There is still stagnation in the second eye.
- The first eyeball goes blind due to the complete death of the nerve. In the other eye, secondary exhaustion develops.
It is worth noting that the above stages can be not only stages of the Foster-Kennedy syndrome, but simply its subspecies that developed independently of each other.
"Reverse" pathology
Sometimes, with the development of brain tumors, the reverse Foster-Kennedy syndrome may occur. That is, nipple congestion from a benign or malignant neoplasm and the usual depletion of a nerve in another eyeball. This is a consequence of the displacing optic canal syndrome. During growth, the neoplasm shifts the brain to the other side, which compresses the intracranial region of the optic nerve. A subsequent increase in pressure inside the cranial box provokes stagnation of the nipple from the side of the neoplasm dislocation. Thus, the reverse Foster-Kennedy syndrome is a symptomatic alienation.
Diagnosis
A diagnosis will require consultation by a neurologist and a neurosurgeon. In addition, it is necessary to undergo a series of examinations:
- ophthalmoscopy;
- measuring the field of view of both manual and automatic static perimetry;
- visometry;
- computed tomography of the brain;
- magnetic resonance imaging of the brain;
- MRI angiography (according to indications).
If a differentiated diagnosis of prechiasmal syndrome is necessary, then it is carried out together with retrobulbar, optical neuritis, as well as macular degeneration and posterior ischemic neuropathy.
Foster Kennedy Syndrome Treatment
Treatment of the pathology depends on the location of the detected tumor or aneurysm. As a rule, it is carried out either by surgical intervention, or through radiation therapy.
Similar diseases
If nipple congestion has developed on one eyeball, and secondary depletion (or 5th stage of nipple stasis) or disk atrophy with residual stasis (stage 4) has developed on another, then these are simply nipples with congestion that have complications. This disease has nothing to do with Foster-Kennedy syndrome.
Also, do not confuse this pathology with cases of dying of the optic nerve associated with disk edema of another apple, which arose against the background of ischemic pinching of the nerve or retrobulbar neuritis.