Visual loss from optochiasmatic arachnoiditis after tuberculous meningitis

1977 ◽  
Vol 46 (4) ◽  
pp. 524-526 ◽  
Author(s):  
R. Michael Scott ◽  
Volker K. H. Sonntag ◽  
Lloyd M. Wilcox ◽  
Lester S. Adelman ◽  
Thomas H. Rockel
Keyword(s):  
Tuberculous Meningitis ◽  
Visual Loss ◽  
Visual Recovery ◽  
Optic Nerves ◽  
Content Type ◽  
Visual Deficit ◽  
Fine Print

✓ While recovering from tuberculous meningitis, a 5-year-old boy developed a profound visual deficit because of optochiasmatic arachnoiditis. Following micro-neurosurgical decompression of the optic nerves and chiasm, prompt visual recovery occurred.

Loss and recovery of vision with suprasellar meningiomas

1975 ◽  
Vol 42 (1) ◽  
pp. 69-75 ◽  
Author(s):  
F. Karl Gregorius ◽  
Robert S. Hepler ◽  
W. Eugene Stern
Keyword(s):  
Visual Acuity ◽  
Tumor Size ◽  
Postoperative Recovery ◽  
The Other ◽  
Anatomical Location ◽  
Optic Nerves ◽  
Content Type ◽  
Visual Deficit ◽  
Postoperative Changes ◽  
Fine Print

✓ Central visual acuity losses were documented in a group of 23 patients with surgically and histologically verified suprasellar meningiomas. The pattern demonstrated was that of acute, gradual or fluctuating loss in one eye, followed by later loss of central acuity in the other eye. Both optic nerves and chiasm were invariably involved either by stretching or compression. Neither preoperative field abnormalities nor central acuity deficits could be correlated with the anatomical location of the tumor, nor could postoperative changes in vision be correlated with tumor size. Lengthy duration of acuity loss and severe visual deficit did not preclude postoperative recovery of vision. Improvement in sight most frequently occurred within the first several weeks after operation, and further return of vision was not noted after 1 year.

Chiasmapexy for the correction of traction on the optic nerves and chiasm associated with their descent into an empty sella turcica

1971 ◽  
Vol 35 (6) ◽  
pp. 760-764 ◽  
Author(s):  
Keasley Welch ◽  
John C. Stears
Keyword(s):  
Visual Loss ◽  
Sella Turcica ◽  
Empty Sella ◽  
Optic Nerves ◽  
Content Type ◽  
Tumor Bed ◽  
Fine Print

✓ A patient recovered full vision after evacuation of a chromaphobe adenoma and subsequent irradiation, but experienced delayed visual loss in the left eye associated with descent of the diaphragm of the sella and the optic nerves and chiasm into the tumor bed. More normal anatomical relationships were restored by inserting silicone sponge beneath the diaphragm of the sella. Vision improved rapidly thereafter and has been maintained for more than 3½ years.

Tuberculoma of the anterior optic pathways

1980 ◽  
Vol 52 (1) ◽  
pp. 129-133 ◽  
Author(s):  
Giorgio Iraci ◽  
Renzo Giordano ◽  
Massimo Gerosa ◽  
Kurt Pardatscher ◽  
Laura Tomazzoli
Keyword(s):  
Diabetes Insipidus ◽  
Tuberculous Meningitis ◽  
Visual Loss ◽  
Tuberculosis Treatment ◽  
Content Type ◽  
Normal Life ◽  
Severe Visual Loss ◽  
Sexual Impotence ◽  
Optic Pathways ◽  
Fine Print

✓ A tuberculoma, encasing the anterior optic pathways in a neoplastiform growth, was found in a 25-year-old man complaining of severe visual loss, diabetes insipidus, and sexual impotence following tuberculous meningitis. Following biopsy and anti-tuberculosis treatment, a satisfactory restoration of sight in one eye allowed the patient to resume an almost normal life.

Surgical experiences with giant intracranial aneurysms

1984 ◽  
Vol 61 (6) ◽  
pp. 1009-1028 ◽  
Author(s):  
Lindsay Symon ◽  
Janos Vajda
Keyword(s):  
Blood Pressure ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Visual Loss ◽  
Considerable Improvement ◽  
Brain Circulation ◽  
Content Type ◽  
Space Occupying Lesion ◽  
Fine Print

✓ A series of 35 patients with 36 giant aneurysms is presented. Thirteen patients presented following subarachnoid hemorrhage (SAH) and 22 with evidence of a space-occupying lesion without recent SAH. The preferred technique of temporary trapping of the aneurysm, evacuation of the contained thrombus, and occlusion of the neck by a suitable clip is described. The danger of attempted ligation in atheromatous vessels is stressed. Intraoperatively, blood pressure was adjusted to keep the general brain circulation within autoregulatory limits. Direct occlusion of the aneurysm was possible in over 80% of the cases. The mortality rate was 8% in 36 operations. Six percent of patients had a poor result. Considerable improvement in visual loss was evident in six of seven patients in whom this was a presenting feature, and in four of seven with disturbed eye movements.

Interoptic course of the anterior cerebral artery associated with anterior cerebral artery aneurysm

1982 ◽  
Vol 56 (2) ◽  
pp. 302-304 ◽  
Author(s):  
Howard J. Senter ◽  
Daniel J. Miller
Keyword(s):  
Carotid Artery ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Optic Nerves ◽  
Content Type ◽  
Anterior Cerebral Artery Aneurysm ◽  
Cerebral Artery Aneurysm ◽  
Fine Print

✓ A ruptured anterior cerebral artery aneurysm is reported in a patient in whom a solitary anterior cerebral artery arose from the proximal carotid artery and ascended between the optic nerves.

Tuberculous brain abscess

1980 ◽  
Vol 52 (3) ◽  
pp. 419-422 ◽  
Author(s):  
P. R. Mata González ◽  
Carlos Vázquez Herrero ◽  
G. Flambert Joachim ◽  
C. Ruiz Ocaña ◽  
G. Cobo Sevilla ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Tuberculous Meningitis ◽  
Previous History ◽  
Miliary Tuberculosis ◽  
Occipital Region ◽  
Content Type ◽  
Tuberculous Abscess ◽  
History Of ◽  
Tuberculous Brain Abscess ◽  
Fine Print

✓ An abscess was removed from the left occipital region in a 73-year-old woman with no previous history of tuberculosis. The patient later died from aspiration bronchopneumonia. Autopsy revealed a basilar tuberculous meningitis and miliary tuberculosis in the peritracheal lymphatic glands, the liver, the spleen, and in isolated areas of the lungs. No chronic tuberculous foci were noted in any area. Including this case, only 18 instances of tuberculous abscess have been reported.

Intrachiasmatic craniopharyngioma: a rare cause of chiasmal thickening

1988 ◽  
Vol 68 (2) ◽  
pp. 300-302 ◽  
Author(s):  
Michael C. Brodsky ◽  
William F. Hoyt ◽  
Stanley L. Barnwell ◽  
Charles B. Wilson
Keyword(s):  
Magnetic Resonance Imaging ◽  
The Other ◽  
Lamina Terminalis ◽  
Normal Vision ◽  
Central Scotoma ◽  
Resonance Imaging ◽  
Optic Nerves ◽  
Content Type ◽  
Anterior Extension ◽  
Fine Print

✓ The authors describe the case of a young man who presented with a central scotoma in one eye and a temporal hemianopsia in the other. Magnetic resonance imaging showed distinctive bilobed thickening of the chiasm and a “potbelly” expansion of the contiguous optic nerves. The distal portions of the intracranial optic nerves appeared normal. At craniotomy, incision of the lamina terminalis exposed intraventricular craniopharyngioma with anterior extension into the chiasm and proximal optic nerves. Partial resection of the tumor restored normal vision.

The central canal of the filum terminale in communicating hydrocephalus

1980 ◽  
Vol 53 (4) ◽  
pp. 528-532 ◽  
Author(s):  
Vijayashekara S. Murthy ◽  
Dhirendra H. Deshpande
Keyword(s):  
Tuberculous Meningitis ◽  
Surgical Procedure ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Filum Terminale ◽  
Ventricular Enlargement ◽  
Content Type ◽  
Fine Print

✓ Lumbar thecoperitoneal shunting was carried out in patients with communicating hydrocephalus due to long-standing tuberculous meningitis. At the time of this surgical procedure, the filum terminale was excised to achieve filum terminostomy. The central canal of the excised filum terminale in seven hydrocephalic children and an equal number from control cases was studied histologically. These observations indicate that the central canal of the filum terminale dilates in communicating hydrocephalus, and the dilatation is proportionate to the lateral ventricular enlargement.

Pituitary apoplexy in a child

1973 ◽  
Vol 39 (4) ◽  
pp. 519-522 ◽  
Author(s):  
Romas Sakalas ◽  
Ronald B. David ◽  
Frederick S. Vines ◽  
Donald P. Becker
Keyword(s):  
Operative Treatment ◽  
Visual Loss ◽  
Pituitary Apoplexy ◽  
Acute Hemorrhage ◽  
Content Type ◽  
Fine Print

✓ A rapidly growing 6-year-old boy with progressive visual loss suddenly became blind following an acute hemorrhage into an eosinophilic adenoma. The case is described and discussed, including the successful operative treatment.

Microsurgical anatomy of the sellar region

1975 ◽  
Vol 43 (3) ◽  
pp. 288-298 ◽  
Author(s):  
Wade H. Renn ◽  
Albert L. Rhoton
Keyword(s):  
Sphenoid Sinus ◽  
Carotid Arteries ◽  
Sella Turcica ◽  
Acute Angle ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Optic Nerves ◽  
Content Type ◽  
Sellar Floor ◽  
Fine Print

✓ Fifty adult sellae and surrounding structures were examined under magnification with special attention given to anatomical variants important to the transfrontal and transsphenoidal surgical approaches. The discovered variants considered disadvantageous to the transsphenoidal approach were as follows: 1) large anterior intercavernous sinuses extending anterior to the gland just posterior to the anterior sellar wall in 10%; 2) a thin diaphragm in 62%, or a diaphragm with a large opening in 56%; 3) carotid arteries exposed in the sphenoid sinus with no bone over them in 4%; 4) carotid arteries that approach within 4 mm of midline within the sella in 10%; 5) optic canals with bone defects exposing the optic nerves in the sphenoid sinus in 4%; 6) a thick sellar floor in 18%; 7) sphenoid sinuses with no major septum in 28% or a sinus with the major septum well off midline in 47%; and 8) a presellar type of sphenoid sinus with no obvious bulge of the sellar floor into the sphenoid sinus in 20%. Variants considered disadvantageous to the transfrontal approach were found as follows: 1) a prefixed chiasm in 10% and a normal chiasm with 2 mm or less between the chiasm and tuberculum sellae in 14%; 2) an acute angle between the optic nerves as they entered the chiasm in 25%; 3) a prominent tuberculum sella protruding above a line connecting the optic nerves as they entered the optic canals in 44%; and 4) carotid arteries approaching within 4 mm of midline within or above the sella turcica in 12%.

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