title: Teaching video neuroimages: pulsatile proptosis.
abstract: A 44-year-old man with neurofibromatosis type 1 had been aware that his right eye pulsated. His visual acuity was 20/15 in both eyes and his intraocular pressures were normal. He had 4 mm of right exophthalmos and there was pulse-synchronous pulsation of the right eye (video on the Neurology® Web site at www.neurology.org). No bruit was heard. Lisch nodules were present on both irides. CT showed a large osseous defect of the greater wing of the right sphenoid bone. The differential diagnosis of pulsatile proptosis includes absence of the sphenoid wing in patients with neurofibromatosis 1,(1) carotid-cavernous fistula, orbital roof fractures, and arteriovenous malformations.(2.)
authors.affiliation: From the Department of Ophthalmology, Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
authors.forename: Thanos D
authors.initials: TD
authors.lastname: Papakostas
authors.forename: Simmons
authors.initials: S
authors.lastname: Lessell
mesh_terms: D000328:Adult; D005094:Exophthalmos / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D009456:Neurofibromatosis 1 / Q000150:complications; D059906:Neuroimaging / Q000379:methods; D009462:Neurology / Q000193:education; D013100:Sphenoid Bone / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods