gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Cavernous haemangioma of the right optic nerve, chiasm and optic tract : case report and review of the literature

Cavernöses Hämangiom des rechten Fasciculus opticus, des Chiasmas und des Tractus opticus : Fallvorstellung und Literaturübersicht

Meeting Abstract

  • corresponding author R. G. Hempelmann - Neurochirurgische Klinik, Städtisches Klinikum Dessau
  • E. Mater - Neurochirurgische Klinik, Städtisches Klinikum Dessau
  • F. Schröder - Neurochirurgische Klinik, Städtisches Klinikum Dessau
  • R. Schön - Neurochirurgische Klinik, Städtisches Klinikum Dessau

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP220

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0488.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Hempelmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Vascular malformations of the intracranial optic pathways are rare. The cardinal symptoms are a sudden or progressive deterioration of the visual acuity, optic field defects and headache. Some patients experience recurrent episodes of this typical trias previous to the first physical examination. The objective of this work was to review the previous literature.

Case report

The 38-year-old male patient was hospitalized because of an acute onset of severe headache and progressive loss of vision, predominantly on the right side. On admission, he was mentally confused and lethargic. The emergency CT scan revealed an acute haemorrhage in the region of the basal cisterns, extending to the right perimesencephalic cistern. The MRI demonstrated a partially cystic and hemorrhagic mass with a slight peripheral enhancement in the suprasellar region and the dorsal part of the gyrus rectus, in direct neighborhood to the optic chiasm. The haemorrhage expanded into the right perimesencephalic cistern and the adjacent parts of the temporal lobe. Furthermore, the MRI demonstrated the existence of multiple cavernous angiomas in the frontal and temporal lobes with two additional haemorrhages. The complete four-vessel angiography demonstrated no pathologic findings. The patient was operated via a pterional approach. The cavernoma, extending from the right optic nerve to the optic tract, was completely removed without further deterioration of the visual acuity.

Results

We found 48 publications presenting 59 cases of vascular malformations of the intracranial optic pathways. 5 lesions were classified as venous angiomas, 12 as arteriovenous malformations, and 33 as cavernous haemangiomas. In 9 cases, the diagnosis of a cavernoma was likely, but pathologically not proven. The cavernoma was completely removed in 20 patients with partial visual recovery in 13 cases. The involvement of the optic nerve, the chiasma, and the optic tract by a cavernoma was reported in only 3 cases. In all of them, a biopsy of the vascular lesion was obtained. To our knowledge, we present the first case of a complete resection of a cavernoma involving the optic nerve, the chiasm, and the optic tract.

Conclusions

This case as well as previous reports show, that a complete removal of cavernomas of the intracranial optic pathways without further deterioration of the visual acuity is possible und should be aimed at.