Optic Nerve Sheath Meningioma Masquerading as Optic Neuritis

Optic neuritis is a common presentation of demyelinating disorders such as multiple sclerosis. It typically presents with acute painful monocular vision loss, whereas chronic optic neuropathy can be caused by compressive lesions along the anterior visual pathway, genetic, toxic, or nutritional causes. We report an unusual presentation mimicking optic neuritis, which was subsequently diagnosed as optic nerve sheath meningioma (ONSM). Misinterpretation of white matter lesions on MRI of brain and the failure to image the optic nerves at the time of acute loss of vision led to the misdiagnosis of optic neuritis in this case. A comprehensive accurate history and ordering the appropriate imaging modality remain paramount in diagnosing progressive visual deterioration.

Download Full-text

Compressive Optic Neuropathy

Neuro-Ophthalmology ◽

10.1093/med/9780190603953.003.0004 ◽

2019 ◽

pp. 21-24

Author(s):

Matthew J. Thurtell ◽

Robert L. Tomsak

Keyword(s):

Optic Nerve ◽

Clinical Features ◽

Optic Neuropathy ◽

Vision Loss ◽

Capillary Hemangioma ◽

Optic Nerve Sheath ◽

Optic Glioma ◽

Compressive Optic Neuropathy ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma

Optic nerve compression results in progressive, and often painless, vision loss. In this chapter, we begin by reviewing the clinical features of anterior and posterior compressive optic neuropathy. We next review the common causes of compressive optic neuropathy, which include orbital tumors (e.g., optic nerve sheath meningioma, optic glioma, and capillary hemangioma), orbital infection, orbital inflammation, intracranial tumors (e.g., pituitary macroadenoma, meningioma, and craniopharyngioma), aneurysm, and thyroid eye disease. We then review the workup for compressive optic neuropathy and discuss the various imaging options. Lastly, we discuss the clinical features, imaging findings, management options, and prognosis for visual recovery for patients with optic nerve sheath meningioma.

Download Full-text

Primary and Secondary Optic Nerve Sheath Meningioma

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1723801 ◽

2021 ◽

Vol 82 (01) ◽

pp. 027-071

Author(s):

Elena Solli ◽

Roger E. Turbin

Keyword(s):

Optic Nerve ◽

Vision Loss ◽

Single Case ◽

Case Reports ◽

Optic Nerve Sheath ◽

Treatment Modalities ◽

Illustrative Case ◽

Nerve Sheath ◽

Pubmed Database ◽

Optic Nerve Sheath Meningioma

Abstract Objective This study was aimed to review issues relating to the recognition, radiographic diagnosis, monitoring, and management of primary and secondary optic nerve sheath meningioma (ONSM). Design This study is a review of peer-reviewed literature combined with illustrative case studies. Participants and Methods A literature search was conducted via the PubMed database using pertinent search terms. Selected articles were limited to those written or translated into English. Additional works cited within articles were also included. Individual cases were drawn from the experience of a tertiary academic neuroophthalmic and orbital practice. Tables summarize radiotherapeutic and surgical studies, excluding single case reports and studies focusing on meningioma of intracranial origin. Main Outcome Measurements Review of reported surgical and radiotherapeutic series is the primary measurement. Results The natural history of optic nerve sheath meningiomas is primarily characterized by progressive ipsilateral vision loss. Diagnosis is typically based on radiographic imaging findings, with biopsy remaining indicated in some patients. Management strategies may include observation, radiation, and/or surgical intervention, or a combination of these approaches. The role of surgery, especially with respect to primary ONSM (pONSM), remains controversial. Advancement of radiotherapy techniques has shifted modern treatment paradigms in pONSM toward radiation as primary treatment, as surgical outcomes are inferior in major studies. Although radiation remains the treatment of choice in many cases, selected patients may benefit from surgery, especially in the setting of secondary ONSM (sONSM). Conclusion A wide variety of radiotherapeutic and surgical treatment modalities for ONSM exist. The specific indications for each management strategy continue to be redefined.

Download Full-text

Blindness due to unrecognized bilateral optic nerve sheath meningioma in a 14-year-old girl (case report)

Neuropediatrics ◽

10.1055/s-0030-1265603 ◽

2010 ◽

Vol 41 (02) ◽

Author(s):

M Pittner ◽

G Kammler ◽

H Zeumer ◽

A Schulz ◽

B Kruse ◽

...

Keyword(s):

Case Report ◽

Optic Nerve ◽

Optic Nerve Sheath ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma

Download Full-text

The Coexistence of Olfactory Groove with Optic Nerve Sheath Meningioma Presenting with Anosmia: Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999201124123954 ◽

2020 ◽

Vol 16 ◽

Author(s):

Hatice Ferhan Kömürcü ◽

Gıyas Ayberk ◽

Ömer Anlar

Keyword(s):

Case Report ◽

Optic Nerve ◽

Visual Impairment ◽

Optic Nerve Sheath ◽

Olfactory Groove ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma ◽

History Of ◽

Olfactory Groove Meningioma ◽

Memory Disturbance

Introduction: Meningiomas are the third most common intracranial tumors in adults after glial tumors and metastases. Olfactory groove meningiomas often grow without symptoms due to their slow growth rates and location in the frontal lobe. Optic nerve sheath meningiomas are benign neoplasms of the meninges surrounding the optic nerve. The coexistence of olfactory groove and optic nerve sheath meningiomas without any history of neurofibromatosis or radiotherapy has never been reported in the literature. Case Report: A 36-year-old female patient presenting with anosmia, headache, memory disturbance, and visual impairment and operated with the diagnosis of olfactory groove meningioma was reported. In the postoperative period, optic nerve sheath meningioma was detected in the imaging performed due to the persistence of visual impairment. Conclusion: Olfactory groove and optic nerve sheath meningiomas are rare tumors and can be diagnosed late because they progress slowly. Early diagnosis and treatment may affect the prognosis and morbidity of these patients favorably.

Download Full-text