Sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage - case report.


Journal

BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802

Informations de publication

Date de publication:
16 Dec 2019
Historique:
received: 19 06 2019
accepted: 21 11 2019
entrez: 18 12 2019
pubmed: 18 12 2019
medline: 4 4 2020
Statut: epublish

Résumé

We report a rare case of sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage. A 45-year-old woman presented decreased visual acuity in both eyes. Her best corrected visual acuity was 0.1 in the right eye and 0.15 in the left eye. Goldmann perimetry showed bilateral central scotomas and bitemporal visual field defects. MRI demonstrated a lesion with mixed hypo- and hyperintensity at the optic chiasm, which was thought to be an intratumoral hemorrhage. The patient underwent bifrontal craniotomy. The tumor was exposed via an anterior interhemispheric approach, and histological evaluation of the mass led to a diagnosis of cavernous angioma. Six months after the surgery, her best corrected visual acuity was 0.9 in the right eye and 0.9 in the left, with slight bitemporal visual field defects. Third ventricular cavernous angioma is considered in the differential diagnosis of chiasmal syndrome. Contrast-enhanced MRI and FDG-PET might be useful for differential diagnosis of cavernous angioma from other chiasmal tumors including glioblastoma.

Sections du résumé

BACKGROUND BACKGROUND
We report a rare case of sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage.
CASE PRESENTATION METHODS
A 45-year-old woman presented decreased visual acuity in both eyes. Her best corrected visual acuity was 0.1 in the right eye and 0.15 in the left eye. Goldmann perimetry showed bilateral central scotomas and bitemporal visual field defects. MRI demonstrated a lesion with mixed hypo- and hyperintensity at the optic chiasm, which was thought to be an intratumoral hemorrhage. The patient underwent bifrontal craniotomy. The tumor was exposed via an anterior interhemispheric approach, and histological evaluation of the mass led to a diagnosis of cavernous angioma. Six months after the surgery, her best corrected visual acuity was 0.9 in the right eye and 0.9 in the left, with slight bitemporal visual field defects.
CONCLUSION CONCLUSIONS
Third ventricular cavernous angioma is considered in the differential diagnosis of chiasmal syndrome. Contrast-enhanced MRI and FDG-PET might be useful for differential diagnosis of cavernous angioma from other chiasmal tumors including glioblastoma.

Identifiants

pubmed: 31842792
doi: 10.1186/s12886-019-1252-5
pii: 10.1186/s12886-019-1252-5
pmc: PMC6916187
doi:

Substances chimiques

Radiopharmaceuticals 0
Fluorodeoxyglucose F18 0Z5B2CJX4D

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

259

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Auteurs

Kan Ishijima (K)

Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.

Yasuhiro Shinmei (Y)

Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan. yshinmei@med.hokudai.ac.jp.

Mayo Nozaki (M)

Umekita Eye Clinic, Osaka, Japan.

Shigeru Yamaguchi (S)

Department of Neurosurgery, Faculty of Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Shinki Chin (S)

Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.

Susumu Ishida (S)

Department of Ophthalmology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.

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Classifications MeSH