title: [Eye symptoms in hypophyseal adenomas, craniopharyngiomas and meningiomas of the anterior and middle cranial fossa].
abstract: Among 181 inpatients suffering from pituitary adenoma, craniopharyngioma, or meningioma of the anterior or middle cranial fossa, 112 had ocular symptoms initially or during the course of the disease. Patients' histories were analyzed with regard to ophthalmological, neurological, and radiological diagnostic procedures carried out, and the conclusions drawn from these. Initial symptoms and signs were often misinterpreted and appropriate investigations consequently delayed. The mean duration of the history was 2.67 years (0-13 years) for the pituitary adenomas, 1.44 years (3 months-6 years) for the craniopharyngiomas and 3.73 years (1 month-24 years) for the meningiomas. Typical initial eye symptoms were progressive loss of vision with or without optic nerve atrophy, visual field defects, extraocular nerve palsies, and exophthalmus, the last two occurring if parasellar extension of the tumor was present. Plain skull X-rays were abnormal in nearly all cases of pituitary adenomas, but the incidence of abnormalities was less frequent with cases of craniopharyngiomas and meningiomas. The tumor was demonstrated by computerized tomography in all cases of pituitary adenomas, in 5 out of 6 cases with craniopharyngiomas and, where the examination was performed before and after administration of contrast medium, in all cases of meningiomas. Introduction of CT, however, shortened the duration of the history only in the meningioma group; the mean dropped from 4.38 years to 3.04 years. The chance of achieving a cure by surgical intervention lessened with both increasing length of history and tumor size. Out of 90 patients (15.6%) operated on, 14 died in the postoperative period. Vision improved postoperatively in only 26 patients whereas it remained unchanged or decreased further in 40 patients. In 10 cases there were no postoperative data available. These results emphasize the necessity of making an early diagnosis. This can nearly always be achieved if a careful clinical examination and adequate additional diagnostic procedures are carried out.
mesh_terms: D000236:Adenoma / Q000150:complications*; D000328:Adult; D000368:Aged; D003397:Craniopharyngioma / Q000150:complications*; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications*; D008579:Meningioma / Q000150:complications*; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology; D009902:Optic Neuritis / Q000209:etiology; D010911:Pituitary Neoplasms / Q000150:complications*; D012607:Scotoma / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000209:etiology; D014794:Visual Fields
vernacular_title: Augensymptome bei Hypophysenadenomen, Kraniopharyngeomen und Meningeomen der vorderen und mittleren Schädelgrube.