In 1911, neurologist Robert Foster-Kennedy identified a previously undescribed syndrome by analyzing medical records. Its essence consisted in the progressive degradation of the nerve and the fall in visual acuity of the first eyeball with the parallel development of disk nerve stagnation 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;
- inflammation of the meninges;
- TBI open or closed type;
- Echinococcosis of the brain;
- aortic sclerosis.
In addition to the above cases, pathology can occur under the influence of diseases of the orbit:
- arachnoidendothelioma growing into the skull through the upper fissure;
- retrobulbar gumma associated with luetic meningitis.
The disease can be provoked by catastrophic changes in the brain in anyregion (occipital, temporal, frontal or parietal) as a symptom in the neighborhood or a symptom at a distance. The latter term refers to the displacement of the brain by a neoplasm or by an enlarged ventricular system.
Mechanism of disease
Foster-Kennedy syndrome is characterized by initial compression of the intracranial portion of the optic nerve. As a result, normal atrophy is formed. If the pathology progresses, the pressure inside the cranium increases. In turn, this provokes nipple congestion in the other eye. At the same time, a similar phenomenon does not develop in the initially affected eye due to atrophy of the optic canal.
An emaciated eye is often prone to the formation of a central scotoma on it, which depends on the drop in the quality of the blood supply to the papillomacular bundle in the intracranial region of the optic nerve.
Stagnation of the nipple of the other eye can be provoked not only by a jump in pressure upwards inside the cranium, but also by the impact 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. The complication is characterized by narrowing of the visual field.
Stages
The course of pathology goes through the following stages:
- Central scotoma is diagnosed on one eyeball, the fundus is without anomalies. The other eye has nipple congestion.
- To the central scotoma of one eyeballdepletion of the optic nerve is added. There is still congestion in the other eye.
- The first eyeball goes blind due to the complete death of the nerve. Secondary wasting develops in the other eye.
It is worth noting that the above stages can be not only stages of the Foster-Kennedy syndrome, but simply its subspecies that have developed independently of each other.
"Reverse" pathology
Sometimes, with the development of neoplasms of the brain, reverse Foster-Kennedy syndrome may occur. That is, nipple congestion from a benign or malignant neoplasm and the usual nerve depletion on the other eyeball. This is a consequence of the shifting optic canal syndrome. During growth, the neoplasm shifts the brain to the other side, which compresses the intracranial portion of the optic nerve. The subsequent increase in pressure inside the cranium provokes stagnation of the nipple from the side of the dislocation of the neoplasm. Thus, reverse Foster-Kennedy syndrome is symptomatic withdrawal.
Diagnosis
To make a diagnosis, you will need to consult a neurologist and a neurosurgeon. In addition, it is necessary to pass a number of examinations:
- ophthalmoscopy;
- measuring the field of view with both manual and automatic static perimetry;
- visometry;
- CT scan of the brain;
- magnetic resonance imaging of the brain;
- MRI angiography (as indicated).
If a differentiated diagnosis of prechiasmatic syndrome is necessary, then it is carried out in conjunction with retrobulbar, optic neuritis, as well as macular degeneration and posterior ischemic neuropathy.
Treatment of Foster-Kennedy syndrome
Treatment of pathology depends on the localization of the detected tumor or aneurysm. Usually done either through surgery or radiation therapy.
Similar diseases
If one eyeball has developed nipple congestion, and the other has secondary wasting (or 5th stage of nipple congestion) or disc atrophy with residual stagnation (4th stage), then these are just nipples with stagnation that have complications. This disease has nothing to do with Foster-Kennedy syndrome.
Also, do not confuse this pathology with cases of death of the optic nerve associated with disc edema of another apple, which arose against the background of ischemic nerve pinching or retrobulbar neuritis.
