Gliomas of the intracranial anterior optic pathways in children. The role of computed tomography, angiography, pneumoencephalography, and radionuclide brain scanning.

Twenty-two gliomas of the anterior optic pathways in children were reviewed, and the relative merits of computed tomography (CT), pneumoencephalography (PEG), angiography, and radionuclide brain scanning were assessed. Contrast-enhanced CT scans proved to be superior in demonstrating the full extracranial extent of the lesions and spread along the optic pathways; however, PEG was more reliable with small chiasmatic lesions. Angiography rarely provided a specific diagnosis of intracranial optic glioma, but in was diagnostic when the intracanalicular or intraorbital portion of the optic nerve was involved. A protocol for neuroradiological investigation of suspected cases is proposed.