Lunardi P, Farah J O, Ruggeri A, Nardacci B, Ferrante L, Puzzilli F
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Neurosurg Rev. 1997;20(3):201-5. doi: 10.1007/BF01105565.
Optic sheath meningocele is rare; only approximately 31 cases have been reported. The term optic sheath meningocele has recently been proposed by Garrity and Forbes to describe primary CSF cysts of the optic nerve sheath, without apical mass or malformation of the cranio-orbital junction. Presenting symptoms are often related to involvement of the optic nerve, with a slow or rapid decrease of visual acuity. CT and MRI studies reveal a tubular-cystic enlargement of the optic nerve/optic sheath complex (on/onsc), with thickening of the optic nerve. Radiological differential diagnosis should include optic nerve tumors such as gliomas, meningiomas, and arachnoid cysts involving the optic nerve sheath. Up to now, it seems that early surgical management by means of optic nerve/optic nerve sheath decompression affords an improvement of visual function with minimal morbidity in patients who present a rapid decrease of visual acuity within 3-6 months. We present an additional case and discuss the clinical, radiological, and operative features of this pathological condition of the optic nerve sheath.
视神经鞘脑膜膨出较为罕见，仅约31例病例被报道。“视神经鞘脑膜膨出”这一术语最近由加里蒂（Garrity）和福布斯（Forbes）提出，用于描述视神经鞘的原发性脑脊液囊肿，无颅眶交界处的顶部肿物或畸形。其呈现的症状通常与视神经受累有关，视力会缓慢或迅速下降。CT和MRI研究显示视神经/视神经鞘复合体（ON/ONSC）呈管状囊性扩大，视神经增厚。放射学鉴别诊断应包括视神经肿瘤，如胶质瘤、脑膜瘤以及累及视神经鞘的蛛网膜囊肿。到目前为止，对于在3 - 6个月内视力迅速下降的患者，通过视神经/视神经鞘减压进行早期手术治疗似乎能改善视觉功能，且发病率最低。我们报告另外1例病例，并讨论这种视神经鞘病理状况的临床、放射学和手术特征。
