Recurrent Germinoma in the Optic Nerve: Report of Two Cases

Neurosurgery ◽  
2001 ◽  
Vol 48 (1) ◽  
pp. 214-218 ◽  
Author(s):  
Takeshi Nakajima ◽  
Toshihiro Kumabe ◽  
Hidefumi Jokura ◽  
Takashi Yoshimoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Complete Response ◽  
Drug Regimen ◽  
Resonance Imaging ◽  
Optic Nerves ◽  
Whole Brain Radiation ◽  
Visual Acuity Loss

Abstract OBJECTIVE AND IMPORTANCE Intracranial germinomas often disseminate via the ventricular and subarachnoid pathways, but seeding to the perioptic arachnoid space is extremely unusual. We report two cases of recurrent germinoma seeding in the optic nerve. CLINICAL PRESENTATION Two men with pure germinoma were initially treated with three cycles of a three-drug regimen of bleomycin, etoposide, and cisplatin, and a complete response was achieved. Patient 1 experienced ventricle wall dissemination 10 months after undergoing the initial treatment and was successfully treated with three cycles of carboplatin and etoposide and then by 24-Gy whole-ventricle radiation. Twelve months later, he complained of progressive visual acuity loss, and magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves. Patient 2 also experienced ventricle wall dissemination 3 months after undergoing the initial chemotherapy, but he exhibited a complete response after undergoing 24-Gy whole-ventricle radiation. Two years later, he complained of progressive visual acuity loss. Magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves and cerebellar hemispheres. INTERVENTION None of the locations of recurrence were included in the irradiation field, whereas there was no recurrence within the radiation field. Complete responses were obtained with three cycles of a three-drug regimen of ifosfamide, cisplatin, and etoposide and then by 24-Gy whole-brain radiation that included the bilateral optic nerves. The visual acuity of each patient improved slightly. CONCLUSION Delayed seeding in the optic nerve may result from germinoma cells that remain dormant, so they cannot be destroyed by chemotherapy regimens alone.

Optic nerve size assessed by magnetic resonance imaging and visual acuity in optic nerve hypoplasia

2021 ◽  
Vol 25 (4) ◽  
pp. e45
Author(s):  
Samantha D. Sagaser ◽  
John C. Benson ◽  
Laurence J. Eckel ◽  
Sasha A. Mansukhani ◽  
Launia White ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Optic Nerve Hypoplasia ◽  
Resonance Imaging

scholarly journals Optic Nerve Tortuosity and Globe Proptosis in Normal and Glaucoma Subjects

2018 ◽  
Author(s):  
Xiaofei Wang ◽  
Helmut Rumpel ◽  
Mani Baskaran ◽  
Tin A Tun ◽  
Nicholas Strouthidis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Eye Movements ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Optic Nerve Head ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Resonance Imaging ◽  
Optic Nerves

AbstractPurposeTo assess the difference in optic nerve tortuosity during eye movements and globe proptosis between primary open angle glaucoma and normal subjects using orbital magnetic resonance imaging.Methods10 Chinese subjects matched for age, ethnicity and refractive errors were recruited, including five normal controls and five patients with primary open angle glaucoma. All subjects underwent magnetic resonance imaging to assess their optic nerves and globes for three eye positions: primary gaze, adduction and abduction. Optic nerve tortuosity (optic nerve length divided by the distance between two ends) and globe proptosis (maximum distance between cornea and interzygomatic line) were measured from magnetic resonance imaging images.ResultsIn adduction, the tortuosity of normal eyes was significantly larger than that of the glaucomatous eyes. Optic nerve tortuosity in adduction in the control and glaucoma groups were 1.004±0.003 (mean ± standard deviation) and 1.001±0.001, respectively (p=0.037). Globe proptosis (primary gaze) in glaucoma subjects (19.14±2.11 mm) was significantly higher than that in control subjects (15.32±2.79 mm; p = 0.046).ConclusionsIn this sample, subjects with glaucoma exhibited more taut optic nerves and more protruding eye globes compared to normal eyes. This may impact optic nerve head deformations in anatomically predisposed patients.PrécisEyes with glaucoma have tauter optic nerves compared with normal eyes, which may exert more force on the optic nerve head tissues during eye movements.

Inflammatory optic neuropathy in granulomatosis with polyangiitis can mimick isolated idiopathic optic neuritis

2019 ◽  
pp. 112067211988900
Author(s):  
Manon Clément ◽  
Antoine Néel ◽  
Frédérique Toulgoat ◽  
Michel Weber ◽  
Pascal Godmer ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Literature Review ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Granulomatosis With Polyangiitis ◽  
Orbital Apex ◽  
Resonance Imaging

Objective: We describe a clinico-radiological presentation of inflammatory optic neuropathy that mimicked optic neuritis. Methods: Retrospective single-center case series and literature review of optic neuropathy without orbital pseudotumor. Results: Five local patients fulfilled the inclusion criteria. Clinical presentation revealed rapidly progressive severe unilateral visual loss, retrobulbar pain (n = 4), and paralytic strabismus (simultaneous = 2, protracted = 2) without proptosis. Optic nerve abnormality was not appreciated on initial scan review. Patients did not have any general activity of the granulomatosis with polyangiitis. Upon follow-up magnetic resonance imaging and initial imaging review, all patients revealed orbital apex anomalies. Visual acuity improved in three patients who received high-dose intravenous glucocorticosteroids immediately. Relapse was frequent and visual outcome was poor (final vision > 20/40 in two patients only). Literature review identified 16 well-documented cases of granulomatosis with polyangiitis–related isolated optic neuropathies. Magnetic resonance imaging revealed no abnormality (n = 6), optic nerve and/or sheath involvement (n = 9), apex infiltration (n = 3), and/or pachymeningitis (n = 7). Conclusion: Granulomatosis with polyangiitis is a rare yet potentially blinding cause of inflammatory optic neuropathy. Optic neuropathy in granulomatosis with polyangiitis may occur in the absence of systemic symptoms of disease activity and is challenging to distinguish from other inflammatory and non-inflammatory disorders affecting visual acuity. Several clinical and imaging clues suggest that optic neuropathy results from the development of an extravascular granulomatous process within the optic nerve sheath in the orbital apex, a place that is difficult to image. In a granulomatosis with polyangiitis patient with unexplained visual loss and a seemingly normal workup (fundoscopy, biology, and imaging), clinician should keep a high index of suspicion.

scholarly journals Migraine or idiopathic intracranial hypertension: Magnetic resonance venography and magnetic resonance imaging findings

2020 ◽  
Vol 33 (3) ◽  
pp. 244-251
Author(s):  
Aynur Guliyeva ◽  
Melda Apaydin ◽  
Yesim Beckmann ◽  
Gulten Sezgin ◽  
Fazil Gelal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Intracranial Pressure ◽  
Pituitary Gland ◽  
Optic Nerve Sheath ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Chi Square ◽  
Nerve Sheath

Background Idiopathic intracranial hypertension (IIH) is a disease characterised by increased cerebral pressure without a mass or hydrocephalus. We aimed to differentiate migraine and IIH patients based on imaging findings. Results Patients with IIH ( n = 32), migraine patients ( n = 34) and control subjects ( n = 33) were evaluated. Routine magnetic resonance imaging, contrast-enhanced 3D magnetic resonance venography and/or T1-weighted 3D gradient-recalled echo were taken with a 1.5 T magnetic resonance scanner. Optic-nerve sheath distention, flattened posterior globe and the height of the pituitary gland were evaluated in the three groups. Transverse sinuses (TS) were evaluated with respect to score of attenuation/stenosis and distribution. Pearson chi-square, Fisher’s exact test and chi-square trend statistical analyses were used for comparisons between the groups. A p-value of <0.05 was considered statistically significant. Decreased pituitary gland height, optic-nerve sheath distention and flattened posterior globe were found to be statistically significant ( p < 0.001) in IIH patients. Bilateral TS stenosis was also more common in IIH patients than in the control group and migraine group ( p = 0.02). Conclusion Decreased pituitary gland height, optic-nerve sheath distention, flattened posterior globe, bilateral stenosis and discontinuity in TS are significant findings in differentiating IIH cases from healthy individuals and migraine patients. Bilateral TS stenosis may be the cause rather than the result of increased intracranial pressure. The increase in intracranial pressure, which is considered to be responsible for the pathophysiology of IIH, is not involved in the pathophysiology of migraine.

Manganese transport in the rat optic nerve evaluated with spatial- and time-resolved magnetic resonance imaging

2010 ◽  
Vol 32 (3) ◽  
pp. 551-560 ◽  
Author(s):  
Øystein Olsen ◽  
Anders Kristoffersen ◽  
Marte Thuen ◽  
Axel Sandvig ◽  
Christian Brekken ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Time Resolved ◽  
Manganese Transport

The predictive value of magnetic resonance imaging of retinoblastoma for the likelihood of high-risk pathologic features

2018 ◽  
Vol 29 (2) ◽  
pp. 262-268 ◽  
Author(s):  
Jamila G Hiasat ◽  
Alaa Saleh ◽  
Maysa Al-Hussaini ◽  
Ibrahim Al Nawaiseh ◽  
Mustafa Mehyar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
High Risk ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Cut Edge ◽  
Pathologic Features ◽  
Nerve Invasion ◽  
Choroidal Invasion

Purpose: To evaluate the predictive value of magnetic resonance imaging in retinoblastoma for the likelihood of high-risk pathologic features. Methods: A retrospective study of 64 eyes enucleated from 60 retinoblastoma patients. Contrast-enhanced magnetic resonance imaging was performed before enucleation. Main outcome measures included demographics, laterality, accuracy, sensitivity, and specificity of magnetic resonance imaging in detecting high-risk pathologic features. Results: Optic nerve invasion and choroidal invasion were seen microscopically in 34 (53%) and 28 (44%) eyes, respectively, while they were detected in magnetic resonance imaging in 22 (34%) and 15 (23%) eyes, respectively. The accuracy of magnetic resonance imaging in detecting prelaminar invasion was 77% (sensitivity 89%, specificity 98%), 56% for laminar invasion (sensitivity 27%, specificity 94%), 84% for postlaminar invasion (sensitivity 42%, specificity 98%), and 100% for optic cut edge invasion (sensitivity100%, specificity 100%). The accuracy of magnetic resonance imaging in detecting focal choroidal invasion was 48% (sensitivity 33%, specificity 97%), and 84% for massive choroidal invasion (sensitivity 53%, specificity 98%), and the accuracy in detecting extrascleral extension was 96% (sensitivity 67%, specificity 98%). Conclusions and relevance: Magnetic resonance imaging should not be the only method to stratify patients at high risk from those who are not, eventhough it can predict with high accuracy extensive postlaminar optic nerve invasion, massive choroidal invasion, and extrascleral tumor extension.

scholarly journals Agreement Between Computed Tomography And Magnetic Resonance Imaging In Measuring Optic Nerve Sheath Diameter

2018 ◽  
Vol 10 (3) ◽  
pp. 22
Author(s):  
Haider N. Al-Tameemi ◽  
Neda M. Helel
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Optic Nerve Sheath Diameter ◽  
Resonance Imaging ◽  
Perfect Agreement ◽  
Nerve Sheath ◽  
The Brain ◽  
Ct And Mri

BACKGROUND: Neuroimaging is increasingly used as a non-invasive method to assess raised intracranial pressure (ICP). Optic nerve sheath diameter (ONSD) measurement using brain magnetic resonance imaging (MRI) has been shown to correlate well with invasively measured ICP, however little research has been conducted on the ONSD measurement using computerized tomography (CT) in correlation with ICP. This study was done to investigate whether CT scan can reliably replace MRI in measuring ONSD.METHOD: A cross-sectional comparative study was conducted on 50 adult patients (29 females and 21 males), who underwent both CT and MRI of the brain along 10-month period. Using the brain axial section, the transverse ONSD was measured at 3 mm behind the globe in both modalities. Agreement between CT and MRI readings was assessed using intraclass correlation (ICC) and Kappa method.RESULTS: There was a strongly positive and statistically significant correlation between ONSD measurement using CT scan and MRI (p value <0.001). There was almost perfect agreement between CT scan and MRI in measuring ONSD (ICC=0.987 and Kappa =0.837). Similar agreement was obtained when cases stratified into normal (≤ 5mm) and thickened (> 5mm) ONSD (ICC=0.947 and 0.972 respectively).CONCLUSION: CT scan is a reliable substitute for MRI in measuring ONSD with almost perfect agreement between the two modalities. It might be good practice to include ONSD measurement in the initial evaluation of brain CT scan in any patient with suspected raised ICP.

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