Visual field deficit caused by vascular compression from a suprasellar meningioma: case report.
OBJECTIVE
Suprasellar meningiomas typically cause bitemporal hemianopsia by direct compression of the chiasm, its blood supply, or both. We report another mechanism for visual loss in suprasellar meningiomas, whereby compression by the suprajacent vascular complex is the offending agent.


METHODS
A 78-year-old woman with a suprasellar meningioma was diagnosed incidentally. During the follow-up period, she developed an inferior homonymous wedge defect consistent with superior compression, without any detectable radiological progression. It was decided to resect her tumor.


METHODS
The patient underwent a fronto-orbital approach for tumoral excision. Intraoperatively, a groove by the anterior cerebral artery complex was found along the superior surface of the chiasm. Postoperatively, the patient's visual deficit resolved.


CONCLUSIONS
This case illustrates an unusual visual field deficit associated with a suprasellar meningioma. It also emphasizes the importance of frequent and careful visual field monitoring, which can precede radiological and symptomatic progression.
Bejjani
Ghassan K
GK
Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. bejjanigk@msx.upmc.edu
Cockerham
Kimberly P
KP
Kennerdell
John S
JS
Maroon
Joseph C
JC
D000368:Aged; D002536:Cerebral Arteries / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D008579:Meningioma / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology; D009897:Optic Chiasm / Q000473:pathology; D012658:Sella Turcica; D014786:Vision Disorders / Q000209:etiology*; D014794:Visual Fields