Primary optic nerve sheath meningiomas

✓ Between 1979 and 1987 the authors treated nine cases of primary optic nerve sheath meningioma. The definitive treatment for these lesions is surgical resection, although no single best plan for optimal management has been determined. The data indicate that only small anterior tumors may be removed with preservation of useful vision. With posterior circumferential tumors, there have been no cases of tumor removal with preservation of vision. A management strategy directed toward preservation of vision is discussed.

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Visual changes after gamma knife surgery for optic nerve tumors

Journal of Neurosurgery ◽

10.3171/sup.2005.102.s_supplement.0143 ◽

2005 ◽

Vol 102 (Special_Supplement) ◽

pp. 143-146 ◽

Cited By ~ 4

Author(s):

Yang Kwon ◽

Jun Seok Bae ◽

Jae Myung Kim ◽

Do Hee Lee ◽

Soon Young Kim ◽

...

Keyword(s):

Optic Nerve ◽

Gamma Knife ◽

Gamma Knife Surgery ◽

Optic Glioma ◽

Content Type ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma ◽

Optic Nerve Tumors ◽

Visual Changes ◽

Fine Print

✓ Tumors involving the optic nerve (optic glioma, optic nerve sheath meningioma) are benign but difficult to treat. Gamma knife surgery (GKS) may be a useful treatment. The authors present data obtained in three such cases and record the effects of GKS.

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Surgical management of meningiomas involving the optic nerve sheath

Journal of Neurosurgery ◽

10.3171/jns.2004.101.6.0951 ◽

2004 ◽

Vol 101 (6) ◽

pp. 951-959 ◽

Cited By ~ 54

Author(s):

Uta Schick ◽

Uwe Dott ◽

Werner Hassler

Keyword(s):

Optic Nerve ◽

Postoperative Radiotherapy ◽

Visual Outcome ◽

Tumor Location ◽

Optic Nerve Sheath ◽

Optic Canal ◽

Content Type ◽

Nerve Sheath ◽

Fine Print

Object. The management of optic nerve sheath meningiomas (ONSMs) remains controversial but includes surgery, radiotherapy, and plain observation. Surgery is often thought to result in postoperative blindness. The authors report on a large series of patients surgically treated for ONSM, with an emphasis on the visual outcome. Methods. Seventy-three patients with ONSMs who had undergone surgery between 1991 and 2002 were retrospectively analyzed. The standard surgical approach consisted of pterional craniotomy, intradural (54 patients) or extradural (10 patients) unroofing of the optic canal, or a combined procedure (seven patients). Thirty-two tumors demonstrated extension through the optic canal. Twenty-nine tumors reached the chiasm or contralateral side. Patients with intraorbital flat tumors should undergo radiotherapy instead of surgery. Those with a large intraorbital mass and no useful vision should undergo surgery. Tumors extending intracranially through the optic canal are amenable to decompression of the optic canal and resection of the intracranial portion. The follow-up period was a mean 45.4 months (range 6–144 months). Ten patients underwent postoperative radiotherapy. Visual acuity was not significantly influenced by surgery but did become worse with a longer duration of preoperative symptoms and a longer follow-up period. A tumor location in the optic canal was another negative factor. Radiotherapy preserved vision in five of 10 cases. Conclusions. The loss of vision in patients with ONSM is only a matter of time. In patients with good vision the role of radiotherapy becomes more important. Surgery is recommended for intracranial tumors to prevent contralateral extension.

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Optimal management in optic nerve sheath meningioma – A multicentre study and pooled data analysis

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2020.08.017 ◽

2020 ◽

Vol 80 ◽

pp. 162-168

Author(s):

Christopher Ovens ◽

Benjamin Dean ◽

Cecelia Gzell ◽

Nitya Patanjali ◽

Benjamin Jonker ◽

...

Keyword(s):

Data Analysis ◽

Optic Nerve ◽

Multicentre Study ◽

Optic Nerve Sheath ◽

Optimal Management ◽

Pooled Data ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma

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Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension

Journal of Neurosurgery ◽

10.3171/jns.1974.41.2.0160 ◽

1974 ◽

Vol 41 (2) ◽

pp. 160-166 ◽

Cited By ~ 98

Author(s):

Paul J. Muller ◽

John H. N. Deck

Keyword(s):

Optic Nerve ◽

Intracranial Hypertension ◽

Venous Hypertension ◽

Optic Nerve Sheath ◽

Consistent Finding ◽

Content Type ◽

Nerve Sheath ◽

Intraocular Hemorrhage ◽

Central Retinal Vein ◽

Fine Print

✓ The eyes of 23 patients with sudden intracranial hypertension were studied at post-mortem. Intraocular hemorrhage had occurred in 37% and optic nerve sheath hemorrhage in 87%. Expansion of the optic nerve sheath, particularly the fusiform retrobulbar portion, was a consistent finding. The subdural space of the optic nerve sheath bore the brunt of the hemorrhage which sometimes communicated with perivascular intradural hemorrhages. Optic nerve sheath hemorrhage is shown to result from rupture of dural and bridging vessels of the optic nerve sheath; this we conclude is subsequent to optic nerve sheath dilatation caused by the transmission of intracranial pressure through the subarachnoid communication between the optic nerve sheath and the intracranial cavity. Intraocular hemorrhage is the result of retinal venous hypertension and rupture brought on by obstruction of both the central retinal vein and the retinochoroidal anastomosis.

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Intracranial pressure following optic nerve decompression for benign intracranial hypertension

Journal of Neurosurgery ◽

10.3171/jns.1981.55.3.0453 ◽

1981 ◽

Vol 55 (3) ◽

pp. 453-456 ◽

Cited By ~ 26

Author(s):

Andrew H. Kaye ◽

J. E. K. Galbraith ◽

John King

Keyword(s):

Optic Nerve ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Continuous Recording ◽

Optic Nerve Sheath ◽

Benign Intracranial Hypertension ◽

Content Type ◽

Nerve Sheath ◽

Before And After ◽

Fine Print

✓ The authors report the case of a patient with benign intracranial hypertension and severe papilledema, who underwent surgery for bilateral optic nerve sheath decompression. No change in the intracranial pressure (ICP) was seen during continuous recording performed before and after the operation. This case supports the contention that the decrease in papilledema and the visual improvements seen following this operation are more likely to be due to decrease in optic nerve sheath pressure than to a generalized decrease in ICP, as suggested by other authors.

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Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests

Journal of Neurosurgery ◽

10.3171/jns.1997.87.1.0034 ◽

1997 ◽

Vol 87 (1) ◽

pp. 34-40 ◽

Cited By ~ 219

Author(s):

Hans-Christian Hansen ◽

Knut Helmke

Keyword(s):

Cerebrospinal Fluid ◽

Optic Nerve ◽

Fluid Pressure ◽

Optic Nerve Sheath ◽

Variable Pressure ◽

Content Type ◽

Csf Pressure ◽

Nerve Sheath ◽

Intrathecal Infusion ◽

Fine Print

✓ Raised intracranial pressure leads to increased pressure around the optic nerve (ON), which underlies the formation of papilledema and the enlargement of the dural optic nerve sheath (ONS). In clinical practice, the presence of widened ONSs is demonstrable on neuroimaging, but their relationship to cerebrospinal fluid (CSF) pressure remains unknown. The authors investigated the ONS response to pressure during CSF absorption studies in 12 patients undergoing neurological testing. The ONS diameter was evaluated by serial B-mode ultrasound scans of the anterior ON near its entry into the globe. All patients tested showed ONS diameter changes that exhibited covariance with the alteration of lumbar CSF pressure and were completely reversible during the infusion tests. The maximum difference in ONS diameter between baseline and peak pressure conditions was 1.8 mm on average (range 0.7–3.1 mm), corresponding to an average ONS diameter variation of 45% (range 15–89%). Regression analysis yielded a linear covariance between ONS diameter and CSF pressure with different slopes across subjects (0.019–0.071 mm/mm Hg, mean r = 0.78). However, this linear relationship was only present within a CSF pressure interval. This interval differed between patients: ONS dilation commenced at pressure thresholds between 15 mm Hg and 30 mm Hg and in some patients saturation of the response (constant ONS diameter) occurred between 30 mm Hg and 40 mm Hg. With a single exception, definitely enlarged ONS diameters (> 5 mm) were present when CSF pressure exceeded levels of 30 mm Hg. Retrospectively, discrimination between normal and elevated outflow resistance was possible on the basis of the ONS response to intrathecal infusion alone. It is concluded that the human ONS has sufficient elasticity to allow a detectable dilation in response to intracranial hypertension. Because of a variable pressure—diameter relationship, the subarachnoid pressure cannot be predicted exactly by single scans. Therefore, the clinical relevance of this method relies on the demonstration of pathologically enlarged sheaths or ongoing enlargement on serial ultrasonography studies.

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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

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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.

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