Document Detail


Progressive peritumoral edema defining the optic fibers and resulting in reversible visual loss.
MedLine Citation:
PMID:  18671645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemangioblastomas are frequently associated with peritumoral edema caused by extravasation of plasma ultrafiltrate through permeable neoplastic vessels. The authors report the clinical and imaging findings in a 62-year-old man with von Hippel-Lindau disease who presented with rapid (within 24 hours) loss of color vision and nearcomplete loss of left eye vision (acuity too poor to test). Serial MR imaging demonstrated a stable vascular tumor in the medioinferior aspect of the left optic nerve, associated with progressive edema extending from the nerve through to the bilateral optic radiations. Complete resection of the lesion was performed via an extended transsphenoidal approach, and histological examination confirmed the lesion was a hemangioblastoma. Postoperatively, the patient recovered color vision and had improvement in visual acuity (20/320). Serial imaging in this unique case captured the progressive extravasation of peritumoral edema that tracked and defined the parallel white matter tracts of first- and second-order neurons of the optic system, causing vision loss. Tumor resection led to resolution of the edema and improvement in visual function.
Authors:
Martin Baggenstos; Emily Chew; John A Butman; Edward H Oldfield; Russell R Lonser
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-09-12     Revised Date:  2010-09-21    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  313-7     Citation Subset:  AIM; IM    
Affiliation:
Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain Edema / etiology,  pathology*
Color Perception
Hemangioblastoma / complications,  pathology*,  surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Optic Nerve / pathology*
Recovery of Function
Retina / pathology
Vision, Low / pathology*
von Hippel-Lindau Disease / complications,  pathology*,  surgery
Grant Support
ID/Acronym/Agency:
Z01 NS003053-01/NS/NINDS NIH HHS
Comments/Corrections

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