继发于胶质瘤的视交叉出血，具有不寻常的磁共振成像表现。
Chiasmal haemorrhage secondary to glioma with unusual MRI appearance.
作者信息
Arrese Ignacio, Sarabia Rosario, Zamora Tomás
机构信息
Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain.
Department of Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain.
出版信息
Neurocirugia (Astur). 2014 May-Jun;25(3):136-9. doi: 10.1016/j.neucir.2013.11.001. Epub 2014 Mar 13.
OBJECTIVE
To report a unique case of haemorrhagic presentation of a chiasmal and optic tract glioma (OPG) appearing as an extra-axial lesion on MRI scans.
CASE REPORT
A 30-year-old female with a preoperative radiological diagnosis of dermoid cyst was operated. No lesion was found in the chiasmal or carotid cisterns within the operative field. The right posterolateral corner of the chiasma and the beginning of the right optic tract appeared swollen. The area was incised and a haemorrhagic fluid poured through the opening. Several samples were taken and the pathological diagnosis was of pilocytic glioma.
CONCLUSIONS
We present a unique case of chiasmal bleeding into the optic pathway secondary to an optic glioma which radiologically mimicked an intracisternal cyst. In similar cases, rapid clinical evolution of the symptoms may be vital for the differential diagnosis. Surgery is warranted to prevent permanent damage to the visual pathway.
目的
报告一例视交叉和视束胶质瘤（OPG）出血表现的独特病例，该病例在MRI扫描中表现为轴外病变。
病例报告
一名30岁女性，术前影像学诊断为皮样囊肿，接受了手术。手术视野内的视交叉或颈动脉池未发现病变。视交叉右后外侧角和右侧视束起始部出现肿胀。切开该区域，有出血性液体从切口流出。采集了多个样本，病理诊断为毛细胞型胶质瘤。
结论
我们报告了一例因视神经胶质瘤导致视交叉出血进入视路的独特病例，该病例在影像学上酷似脑池内囊肿。在类似病例中，症状的快速临床进展对于鉴别诊断可能至关重要。有必要进行手术以防止对视路造成永久性损伤。
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