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病例报告:大型凸面脑膜瘤引起的非典型视觉表现——神经牵拉和蒂部受压效应。

Case Report: Atypical visual presentation caused by a large convexity meningioma-a nerve stretching and stalk indentation effect.

作者信息

Chiu Chia-Hsun, Chen Ko-Ting

机构信息

Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

出版信息

Front Surg. 2024 Jul 18;11:1399163. doi: 10.3389/fsurg.2024.1399163. eCollection 2024.

Abstract

Visual field defects are commonly present in patients with brain tumors, particularly due to direct compression on the optic apparatus. However, there are instances where brain tumors, despite not directly compressing the optic pathway, can still cause visual symptoms, albeit rarely reported but not uncommonly observed. These mechanisms are thought to be associated with increased intracranial pressure (IICP). We report a case of a 32-year-old man who presented with right blurred vision and was diagnosed with a right convexity meningioma. Upon reviewing his magnetic resonance images, we hypothesized that the indentation of the pituitary stalk on the optic chiasm and the stretching of the optic nerve, combined with a focal effect of IICP, could be responsible for his atypical visual field defect.

摘要

视野缺损在脑肿瘤患者中很常见,尤其是由于对视神经装置的直接压迫。然而,在某些情况下,脑肿瘤尽管没有直接压迫视路,但仍可引起视觉症状,尽管报道很少,但并非不常见。这些机制被认为与颅内压升高(IICP)有关。我们报告一例32岁男性,表现为右眼视力模糊,被诊断为右凸面脑膜瘤。在查看他的磁共振图像时,我们推测垂体柄对视交叉的压迫以及视神经的拉伸,再加上IICP的局灶性作用,可能是导致他非典型视野缺损的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388b/11291257/8d899221a36d/fsurg-11-1399163-g001.jpg

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