[Visual impairment complicated with meningioma].

Among 106 patients of meningioma surgically experienced the past 10 years between 1981 and 1990, twelve of meningioma with progressive visual impairment were analyzed in relation to postoperative visual outcome. There were four males and eight females, and the age ranged from 33 to 61 years with the average 48 years. The distribution of tumor location was 6 cases in tuberculum sellae, 3 cases in the inner side of sphenoid ridge, and 3 cases in olfactory groove. The size of tumor in each case was 2 to 7 cm in diameter, and in 8 cases more than 3 cm. The duration of visual disturbance was between 3 months and 10 years with the average 3 years. For all cases, surgical removal of the tumor was performed totally by pterional and bifrontal approach. Consequently, 58.3% of 7 cases had improved vision postoperatively, 16.7% of 2 cases remained unchanged, and 25.0% of 3 cases were worse, including one case of malignant meningioma, Visual outcome was mainly affected by a duration of symptoms, a tumor size, a preoperative visual impairment, and in special, a situation of optic nerve where compression of tumor itself and adherence to the surrounding tissues took place. On operation, great care should be paid for a case of long-standing, severe visual disturbance as demonstrating hemianopsia with visual narrowing less than 50 degree by perimetry, and also for preservation of the feeding arteries of optic nerves.