Manor R S, Israeli J, Sandbank U
Arch Ophthalmol. 1976 Jul;94(7):1142-4. doi: 10.1001/archopht.1976.03910040054010.
In a 70-year-old man with glioma of the optic nerves and tracts, the initial symptom was a unilateral loss of vision that progressed rapidly and was followed by amaurosis of both eyes. All diagnostic radiological procedures were negative. Four months after the onset of the disease, the patient developed hemiplegia, became comatose, and died. Post-mortem examination revealed a glioblastoma multiforme of both optic nerves, chiasma, and optic tracts that extended posteriorly into the left thalamus and medial geniculate body. The tumoral thickening of the optic nerves was absent in the intracanalicular part, a finding that concurred with the normal radiological appearance of the optic foramen. Glioblastoma multiforme of the optic pathways should be included in the differential diagnosis of acute visual failure in elderly people, even though the final diagnosis may be possible only at postmortem examination.
一名70岁男性患有视神经和视束胶质瘤,最初症状为单眼视力丧失,且迅速进展,随后双眼失明。所有诊断性放射学检查均为阴性。发病4个月后,患者出现偏瘫、昏迷并死亡。尸检发现双侧视神经、视交叉和视束存在多形性胶质母细胞瘤,肿瘤向后延伸至左侧丘脑和内侧膝状体。视神经管内部分未出现肿瘤性增厚,这一发现与视神经孔的正常放射学表现相符。视神经通路的多形性胶质母细胞瘤应纳入老年人急性视力丧失的鉴别诊断,尽管最终诊断可能仅在尸检时才能明确。