Inami Kasumi, Tsutsumi Satoshi, Hashizume Akane, Yoshida Kohei, Sugiyama Natsuki, Ueno Hideaki, Ishii Hisato
Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Japan.
Surg Neurol Int. 2023 Jul 14;14:248. doi: 10.25259/SNI_364_2023. eCollection 2023.
Rhabdoid meningiomas (RMs) are a rare type of malignant meningioma. Here, we report a case of intracranial RM presenting with visual disturbance and prominent hyperintensity in the optic nerve (ON).
A 20-year-old female presented with a 1-year history of headache. At presentation, her visual acuity (VA) was 20/50 on the right side and 20/40 on the left, with an intraocular pressure of 17 mmHg on both sides. Cerebral magnetic resonance imaging revealed a broad-based tumor in the right frontal convexity. It measured 82 mm × 65 mm × 70 mm in diameter, accompanied by cystic components, and was inhomogeneously enhanced. The intraorbital ONs demonstrated prominent intramedullary hyperintensity on the constructive interference steady-state sequence. Gross total tumor resection was performed and the pathology was consistent with RM. Immediately after surgery, her VA and IOP were 20/17 and 10 mmHg, respectively, with a remarkable resolution of the intramedullary hyperintensity.
Prominent hyperintensity in the ON identified in patients with chronic intracranial hypertension may be an indicator of visual disturbance. It can rapidly resolve after resolution of intracranial hypertension with functional recovery.
横纹肌样脑膜瘤（RMs）是一种罕见的恶性脑膜瘤。在此，我们报告一例颅内RMs患者，其表现为视力障碍且视神经（ON）显著高信号。
一名20岁女性，有1年头痛病史。就诊时，其右眼视力（VA）为20/50，左眼为20/40，双侧眼压均为17 mmHg。脑部磁共振成像显示右侧额部凸面有一个基底较宽的肿瘤。直径为82 mm×65 mm×70 mm，伴有囊性成分，呈不均匀强化。眼眶内视神经在稳态构成干扰序列上显示出显著的髓内高信号。进行了肿瘤全切，病理结果符合RMs。术后即刻，其视力和眼压分别为20/17和10 mmHg，髓内高信号明显消退。
慢性颅内高压患者视神经中显著的高信号可能是视力障碍的一个指标。颅内高压缓解后，随着功能恢复，其可迅速消退。
