An unusual parasagittal tumour with acute blindness and response to cerebrospinal fluid shunting.
We report a seven-year-old girl who presented with a sudden tumor apoplexy due to a parasagittal hemangiopericytoma. Following tumor excision, the child was noted to have bilateral optic nerve dysfunction and progressive papilledema, despite rapid overall neurological improvement. Based on the clinical features, we feel that this case represents an unusual form of visual deterioration related to impaired CSF absorption somehow precipitated by the acute tumour apoplexy. This unusual case of blindness responded significantly to CSF shunting. Several reports exist describing raised intracranial pressure with papilledema caused by nonthrombotic sinus occlusion due to tumors in proximity to the posterior superior sagittal sinus, torcular herophili and the jugular outlet. Communicating hydrocephalus, pseudotumor syndrome or intracranial venous sinus obstruction should be considered when otherwise inexplicable visual loss coexists with optic nerve dysfunction and papilledema. We emphasize the importance of a thorough search for the cause of visual loss.
Pillai
A
A
Department of Neurosurgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Amrita Lane, Elamakkara P.O. Kochi 682026, Kerala, India 682026.
Kumar
S
S
Kumar
A
A
Panikar
D
D
D000208:Acute Disease; D001766:Blindness / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D005260:Female; D006393:Hemangiopericytoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011559:Pseudotumor Cerebri / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed