Shibuya M, Baskaya M K, Saito K, Suzuki Y, Ooka K, Hara M
Department of Neurosurgery, Nagoya University School of Medicine, Japan.
Acta Neurochir (Wien). 1995;136(1-2):29-36. doi: 10.1007/BF01411432.
Two cases of cavernous malformation of the optic chiasm are reported, and 12 previously reported cases are reviewed. The first patient presented with gradually progressive and the second patient with a subacute chiasmal syndrome. Total excision was performed in both cases. Visual function improved slightly after surgery in the first patient while the other showed marked improvement. Although cavernous malformations are angiographically occult, pre-operative diagnosis has become possible based on the characteristic features such as repeated haemorrhages in multiple sinusoidal structures as revealed by magnetic resonance imaging (MRI). A gliotic interspace between the malformation and normal neural tissue provides a plane of cleavage for dissection which permits total excision without causing new deficits. Review of previously reported cases revealed that chiasmal cavernous malformations haemorrhage more frequently than those in the brain. Early diagnosis with total excision is the treatment of choice for cavernous malformations of the optic chiasma.
本文报告了2例视交叉海绵状畸形病例，并回顾了12例既往报道的病例。首例患者表现为渐进性症状，第二例患者表现为亚急性视交叉综合征。两例均行全切术。首例患者术后视力功能稍有改善，另一例则有明显改善。尽管海绵状畸形在血管造影上不显影，但基于磁共振成像（MRI）显示的多窦状结构反复出血等特征，术前诊断已成为可能。畸形与正常神经组织之间的胶质间隙为分离提供了一个劈开平面，从而可以全切而不造成新的功能缺损。对既往报道病例的回顾显示，视交叉海绵状畸形比脑内海绵状畸形更容易出血。早期诊断并全切是视交叉海绵状畸形的首选治疗方法。
