Unexplained Loss of Vision in a Child: Consider Bilateral Primary Optic Nerve Sheath Meningioma

Abstract

A 4-year-old girl gradually lost her vision to become practically blind at the age of 10 years. Examinations at several medical centers had been unable to establish an etiology. Traditional investigation using cerebral magnetic resonance imaging (MRI) initially showed normal results; however, later on it showed progressive atrophy of both optical nerves without recognizable cause. Subsequently, MRI including adequate orbital sequences, contrast-enhanced sequences, and fat suppression demonstrated bilateral primary optic nerve sheath meningioma, a rare but treatable tumor of childhood. The patient underwent neurosurgery and to date retains minimal vision. Adequate neuroradiological investigation of unexplained optic atrophy is advocated.

Keywords

optic nerve tumor - optic nerve atrophy - bilateral visual loss - child

Author Contributions

M.N. and A.K. provided the case history and drafted the article. U.L. and B.H. described the neuroradiological methods and findings as well as reviewed and wrote the article. G.K. participated in the neurosurgical treatment of the patient as well as read and corrected the article. J.M. performed and described the neuropathological investigations as well as read and corrected the article. A.S. contributed to the diagnosis and care of the patient as well as read and corrected the article.

Ethical Approval

Written consent for publication was obtained from the patient having reached adulthood.

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