Primary optic nerve sheath meningiomas. Report of seven cases (clinical neuroradiological, pathological and surgical considerations in seven cases).

Between 1985 and 1993, we treated seven cases of optic nerve sheath meningiomas. The median age at onset of their symptoms was 42.14 years. All of the patients were aged between 27 and 60 females with a slowly progressive lesion. Computed tomography and/or magnetic resonance imaging were used as diagnostic procedure in our cases. We operated on using microsurgical techniques in all of these cases. Vision was preserved in the three of our cases. The definitive treatment for these lesions is surgical resection, although no single best plan for optimal management has been determined. The data indicate that only small anterior tumors may be removed with preservation of useful vision. With posterior circumferential tumors, there have been no cases of tumor removal with preservation of vision. A management strategy directed toward preservation of vision is discussed.