Departments of Ophthalmology (WJA, MAG, SMC), Pathology (MAG), and Neurology (SMC), Saint Louis University School of Medicine, St. Louis, Missouri; and Department of Radiology (AS), Washington University School of Medicine, St. Louis, Missouri.
J Neuroophthalmol. 2020 Dec;40(4):533-537. doi: 10.1097/WNO.0000000000000959.
A 26-year-old woman presented for a routine contact lens evaluation but was found to have a subtle right sixth nerve paresis and adducting nystagmus of the left eye. She reported horizontal diplopia on far right gaze as well as subjective right-sided weakness and poor balance for 1 year. Brain and spinal MRI revealed multiple cystic lesions with variable enhancement throughout the posterior fossa and cervical spinal cord. These MRI findings were highly suspicious for an infectious central nervous system process, such as neurocysticercosis; however, primary or metastatic tumors were also important considerations. Tumor location and imaging characteristics were most helpful in differentiating among these etiologies. A brain biopsy ultimately established the diagnosis of a rosette-forming glioneuronal tumor.
一位 26 岁女性前来进行常规隐形眼镜评估，却被发现存在右侧第六脑神经细微瘫痪和左眼内收性眼球震颤。她报告说，在向右凝视时出现水平复视，同时在过去 1 年中感到右侧无力和平衡不佳。脑部和脊髓 MRI 显示在后颅窝和颈脊髓中有多个囊状病变，伴有不同程度的强化。这些 MRI 发现高度提示感染性中枢神经系统疾病，如神经囊尾蚴病；然而，原发性或转移性肿瘤也是重要的考虑因素。肿瘤位置和影像学特征对于区分这些病因最为有帮助。脑部活检最终确定了玫瑰花形成的神经胶质神经元肿瘤的诊断。
