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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(06): 407
DOI: 10.1590/0004-282X20170065
IMAGES IN NEUROLOGY

Optochiasmatic cavernous malformation: a rare cause of acute vision loss

Malformação cavernosa óptico-quiasmática: uma causa rara de perda de visão aguda
Bruno Niemeyer de Freitas Ribeiro
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil;
,
Bernardo Carvalho Muniz
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil;
,
Nina Ventura Wilner
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil;
,
Emerson Leandro Gasparetto
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil;
,
Edson Marchiori
2   Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
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A 63-year-old woman experienced the sudden onset of left retro-orbital pain and left visual disturbance. Neurological examination revealed decreased left visual acuity. Magnetic resonance imaging revealed a mass with mixed signal intensity at the left optic nerve and optic chiasm ([Figure]). Left frontotemporal craniotomy was performed using the pterional approach, and histological examination of the specimens confirmed cavernous malformation. Postoperatively, the patient’s left visual acuity improved slightly, but the visual field defect was unchanged.

Zoom Image
Figure MRI, STIR (A,B), and T1-weighted images before (C) and after (D) gadolinium administration, showing the optochiasmatic cavernous malformation (white arrow) surrounded by a hemosiderin ring with no gadolinium enhancement. MRI: magnetic resonance imaging; STIR: short tau inversion recovery.

Cavernous malformations of the optic chiasm are unusual lesions. The presenting symptoms range from progressive vision loss or pituitary disturbances to chiasmal apoplexy syndrome. Symptomatic cavernous malformations of the optic chiasm are generally treated surgically[1],[2].


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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Alafaci C, Grasso G, Granata F, Cutugno M, Marino D, Salpietro FM et al. Cavernous malformation of the optic chiasm: an uncommon location. Surg Neurol Int. 2015;6:60. https://doi.org/10.4103/2152-7806.155256
  • 2 Liu JK, Lu Y, Raslan AM, Gultekin SH, Delashaw JB Jr. Cavernous malformations of the optic pathway and hypothalamus: analysis of 65 cases in the literature. Neurosurg Focus. 2010;29(3):E17. https://doi.org/10.3171/2010.5.FOCUS10129

Address for correspondence

Bruno Niemeyer de Freitas Ribeiro
Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia; Rua do Rezende, 156; 20231-091 Rio de Janeiro RJ
Brasil   

Publication History

Received: 02 August 2016

Accepted: 14 March 2017

Article published online:
05 September 2023

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  • References

  • 1 Alafaci C, Grasso G, Granata F, Cutugno M, Marino D, Salpietro FM et al. Cavernous malformation of the optic chiasm: an uncommon location. Surg Neurol Int. 2015;6:60. https://doi.org/10.4103/2152-7806.155256
  • 2 Liu JK, Lu Y, Raslan AM, Gultekin SH, Delashaw JB Jr. Cavernous malformations of the optic pathway and hypothalamus: analysis of 65 cases in the literature. Neurosurg Focus. 2010;29(3):E17. https://doi.org/10.3171/2010.5.FOCUS10129

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Zoom Image
Figure MRI, STIR (A,B), and T1-weighted images before (C) and after (D) gadolinium administration, showing the optochiasmatic cavernous malformation (white arrow) surrounded by a hemosiderin ring with no gadolinium enhancement. MRI: magnetic resonance imaging; STIR: short tau inversion recovery.