title: Occult vascular malformations of the optic chiasm: magnetic resonance imaging diagnosis and surgical laser resection.
abstract: Angiographically occult vascular malformations of the optic nerve and chiasm are extremely rare. Before the advent of magnetic resonance imaging (MRI), it was difficult to diagnose these lesions preoperatively. We report MRI scan findings of optic chiasm cavernous angiomas in two patients with chiasmal syndrome. MRI was useful in localizing the vascular malformation and delineating its characteristics, especially chronic hemorrhage. One patient underwent biopsy of the lesion. The other patient underwent complete microsurgical resection of the malformation with the carbon dioxide laser with preservation of vision. Occult vascular malformations of the optic nerve and chiasm may be a more common cause of visual deterioration than previously recognized. The MRI scan is the imaging modality of choice for diagnosing and following these lesions. In certain patients, these vascular malformations may be amenable to complete surgical removal with stabilization or improvement of visual function.
authors.affiliation: Division of Neurosurgery, stanford University Medical Center, California.
authors.forename: G K
authors.initials: GK
authors.lastname: Steinberg
authors.forename: M P
authors.initials: MP
authors.lastname: Marks
authors.forename: L M
authors.initials: LM
authors.lastname: Shuer
authors.forename: R L
authors.initials: RL
authors.lastname: Sogg
authors.forename: D R
authors.initials: DR
authors.lastname: Enzmann
authors.forename: G D
authors.initials: GD
authors.lastname: Silverberg
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D053685:Laser Therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm / Q000098:blood supply*; D014786:Vision Disorders / Q000209:etiology