ABSTRACT
Optic nerve sheath meningiomas, formerly thought to be rare, have been encountered with surprising frequency since the widespread use of computed tomography. Early diagnosis led to an enthusiastic surgical approach to these lesions, but this has been tempered by the realization that even in the best of hands, blindness followed such surgery with distressing frequency. Optic nerve sheath meningiomas may be divided into primary, secondary, and multiple meningioma groups. Five patients with primary optic nerve sheath meningiomas treated with irradiation therapy are presented in this report. Improvement in visual acuity, stabilization to increase in the visual field, and decrease in size to total regression of optociliary veins, have been documented following irradiation therapy of the posterior orbital and intracanalicular portions of the optic nerve in some of these cases. Although each patient must be carefully individualized, there is no question that visual palliation can be achieved in some cases of optic nerve sheath meningioma. Further investigation of this therapeutic modality in selected cases in advised.
Subject(s)
Cranial Nerve Neoplasms/radiotherapy , Meningeal Neoplasms/radiotherapy , Meningioma/radiotherapy , Optic Nerve Diseases/radiotherapy , Adult , Color Perception/radiation effects , Cranial Nerve Neoplasms/diagnosis , Female , Fluorescein Angiography , Humans , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Middle Aged , Optic Nerve Diseases/diagnosis , Radiotherapy, High-Energy , Tomography, X-Ray Computed , Visual Acuity/radiation effects , Visual Fields/radiation effectsABSTRACT
Giant aneurysms of the carotid artery commonly produce a visual loss as their main or only clinical manifestation. On occasion they do not respond favorably to ligation of the carotid artery in the neck or even to direct surgical attack on the related carotid artery intracranially. In such cases additional ligation of the contralateral external carotid artery should be considered. Such a case is presented and the rational for such treatment discussed.