Jimenez Hakim Enrique, Garcia Rairan Luis, Guzman Julian, Araque Yessid
1Department of Neurosurgery, Fundacion Santa Fe de Bogotá, Bogotá, Colombia.
2Faculty of Medicine, Universidad El Bosque, Bogotá, Colombia; and.
J Neurosurg Case Lessons. 2023 Aug 7;6(6). doi: 10.3171/CASE23145.
A glomus vagale tumor is an infrequent paraganglioma primarily characterized by auditory symptoms, cranial nerve involvement, or autonomic symptoms. However, visual involvement is not commonly observed, and to date, no cases have been reported in the literature.
The case involves a 62-year-old female patient with a history of right carotid body tumor resection. She presented to the emergency department with a sudden decrease in visual acuity and bitemporal hemianopsia, accompanied by a left parietal headache. Initial brain magnetic resonance imaging (MRI) revealed a pituitary macroadenoma, which was completely resected. However, postoperatively, the patient developed left amaurosis. Subsequent brain MRI showed the presence of hemostatic material mixed with blood in the sellar region, causing displacement of the optic chiasm. A repeat intervention was performed, identifying bleeding from both cavernous sinuses. Head and neck angiography demonstrated a right glomus vagale tumor with abundant blood drainage into the right cavernous sinus. Embolization of the glomus vagale tumor was performed, resulting in no further bleeding and improvement of symptoms.
The aim of this case report is to describe a rare occurrence of bilateral visual disturbances caused by bleeding in both cavernous sinuses due to venous hypertension caused by a right glomus vagale tumor.
迷走神经球瘤是一种罕见的副神经节瘤，主要表现为听觉症状、颅神经受累或自主神经症状。然而，视觉受累并不常见，迄今为止，文献中尚未有相关病例报道。
该病例为一名62岁女性患者，有右侧颈动脉体瘤切除病史。她因视力突然下降和双颞侧偏盲伴左侧顶叶头痛就诊于急诊科。最初的脑部磁共振成像（MRI）显示为垂体大腺瘤，已完全切除。然而，术后患者出现左眼黑矇。随后的脑部MRI显示蝶鞍区有与血液混合的止血材料，导致视交叉移位。进行了再次干预，发现双侧海绵窦出血。头颈部血管造影显示右侧迷走神经球瘤，有大量血液引流至右侧海绵窦。对迷走神经球瘤进行了栓塞治疗，出血停止，症状改善。
本病例报告的目的是描述一例罕见的由右侧迷走神经球瘤导致静脉高压引起双侧海绵窦出血所致的双侧视觉障碍。
