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PubMed1982

[A case of cavernous hemangioma with acute visual disturbance (author's transl)].

The authors report a case of parasellar cavernous hemangioma having grown to the suprasellar region within 3 year's period and showing acute visual disturbance caused by intratumoral hemorrhage. A 44-year-old woman, who had experienced spontaneous intracerebral hematoma in the left inferior frontal lobe 3 years ago and then obtained good recovery in the post-operative period had suddenly developed decreased visual acuity of the left eye without other neurological deficit. CT scan revealed an irregular mass lesion in the chiasmal region, which had a crown-like high density area over the suprasellar low density. Carotid angiogram showed a suprasellar avascular mass and the left A1 segment showed marked narrowing. Neither tumor nor venous pooling was visible in the capillary and venous phase. Surgery disclosed a reddish dark tumor with thin capsular wall, extending from the left cavernous sinus to the suprasellar region, and it was accompanied by intratumoral hemorrhage compressing the left optic nerve. The tumor was subtotally removed. High density area on the precontrast scan was confirmed to be intratumoral hemorrhage and the low density area was of organized tissue due to thrombosis. Histological finding was compatible to cavernous hemangioma. Postoperatively visual acuity of the patient was well recovered, but left 3rd and 6th cranial nerve palsy followed. The authors discussed the mechanism of acute onset and CT findings of the cavernous hemangioma arising in the chiasmal region with a review of literature.

Adult↗
PubMed1982

[Psychopathology and neuro-ophthalmology in meningioma of the olfactory groove].

In 14 patients with a surgically nad histopathologically verified meningioma of the olfactory nerve groove (OGM) (12 women, 2 men), clinical findings and diagnosis were analysed, especially with respect to neuropathology and psychopathology. The apodictic theorem that an OGM leads to a Foster-Kennedy syndrome as well as to a psychopathological orbital brain syndrome cannot be maintained. The Foster-Kennedy syndrome does not occur in a characteristically high incidence, and psychopathologically an orbital brain syndrome can only be diagnosed in case of an anterior location of the OGM. The more the OGM shows starting point or growth development to or from the anterior chiasmal angle, the more is resembles that psychopathological syndrome that we have found and described for the meningioma of the Tuberculus sellae.

Brain Neoplasms↗
PubMed1982

[Spontaneous intracerebral hematomas: occipital lobe hemorrhages].

Spontaneous intracerebral hematomas can be diagnosed immediately and localized exactly by the means of cranial computerized tomography. The occipital lobe is a relatively rare site of hypertensive hematomas which are the most frequent etiologic group. Out of 264 patients with intracerebral hematomas ion cranial computerized tomography we found the occipital lobes affected in 24 cases i.e. 9%. 116 patients with intracerebral hematomas treated in the neurologic clinic demonstrated in 15 cases (13%) occipital localization. In 7 patients bleedings were of hypertensive origin, in 4 cases etiology was unknown, in one case it originated from an arteriovenous angioma and in 3 cases congophilic (amyloid) angiopathy was the basic disease. In smaller occipital hematomas the clinical symptoms are relatively mild, mainly consisting of acute headache and hemianopsia. If the hematoma is limited to the occipital lobe the prognosis is favorable both with or without neurosurgical treatment.

Adult↗
PubMed1982

[Craniopharyngioma in adults].

Initial signs of a craniopharyngioma in a 58 years old woman were a decrease in visual acuity and suppression of the pupillary light reflex. Perimetric signs were: left: central scotoma with an inferior temporal defect of the peripheral field; right: superior temporal field defect. The CT scan showed an intrasellar tumor, extending into the suprasellar region, isodensity of the tumor being the main finding. The radiological diagnosis was adenoma, but all the perimetric defects disappeared spontaneously, and the post-operative diagnosis was craniopharyngioma. Variations of the visual field defect are one of the most typical signs of craniopharyngioma, and absence of calcification, with isodensity of the tumor on the CT scan may lead to a mistaken.

Craniopharyngioma↗
PubMed1978

Primary empty sella syndrome and benign intracranial hypertension.

Two patients presenting with headache and radiological features of an enlarged sella turcica were found to have the primary empty sell syndrome. Whilst under observation, 1 patient developed papilloedema and was shown to have benign intracranial hypertension. The second patient also had raised intracranial pressure. A relationship between the empty sella syndrome and benign intracranial hypertension has previously been reported and it is suggested that in a patient with a congenitally incompetent diaphragma sella, chronically raised intracranial pressure caused herniation of the subarachnoid space into the sella turcica. Subsequently, sella turcica enlargement and remodelling occurs, sometimes with endocrine, visual and other sequelae. The clinical, radiological and CT scan features of the empty sella syndrome are discussed and the indications for major radiological studies are considered.

Adult↗
PubMed1979

Visual implications of diagnostic advances in neurology.

Two major diagnostic advances in neurology which have visual implications are Computerized Axial Tomography (CAT Scan) and Evoked Potentials. This paper briefly discusses the basic concepts of the CAT Scan and of Evoked Potentials. In addition, it includes select clinical applicability of each.

Brain Diseases↗
PubMed1995

Peripartum hypopituitarism and lymphocytic hypophysitis.

The classical cause of postpartum hypopituitarism is Sheehan's syndrome, in which an obstetric catastrophe is associated with hypotension. However, with improvements in obstetric care, the most common cause now may be lymphocytic hypophysitis. Five women with postpartum hypopituitarism, whose symptoms occurred during or immediately after pregnancy, had detailed endocrine and pituitary imaging for the duration of follow-up. Two presented with visual symptoms, and three with non-specific illnesses related to varying deficiencies of anterior pituitary hormones. Four were unable to lactate, and four were initially amenorrhoeic. Initially, four of the five women had enlarged pituitary glands on magnetic resonance imaging. Four have to some extent recovered pituitary function. One patient had associated thyroiditis: in two cases antinuclear antibodies became positive during follow-up, and in one of these dsDNA antibody was also detected. In no case were pituitary antibodies detected. None had complicated pregnancies or deliveries, and the two who had caesarean sections had no episodes of hypotension. The presentation of secondary hypothyroidism combined with ACTH deficiency in four of the five women strongly suggests lymphocytic hypophysitis. This diagnosis should be considered in postpartum women with general malaise and persistent amenorrhoea, as well as in women who develop visual impairment in the last trimester of pregnancy without antecedent pituitary disease. A conservative policy of management of the pituitary enlargement should be pursued as this resolves.

Adrenocorticotropic Hormone↗