title: Anterior cerebral artery notching on anterior optic pathways in a child with craniopharyngioma and progressive blindness.
abstract: We report the clinical significance of anterior cerebral artery (ACA) notching on the optic nerve and chiasm in a 3.5-year-old girl with a craniopharyngioma and progressive blindness. She presented with a headache and vomiting, followed by binocular blindness. Magnetic resonance imaging (MRI) studies demonstrated severely distended A1 segments and ill-depicted ACAs. Surgical decompression via a right subfrontal approach was performed to reverse blindness. Postoperative MRI studies showed good ACA visualization. A second operation via a right pterional approach revealed ACA notching, which appeared as a transverse groove on the right optic nerve and chiasm. ACA notching should be considered as a possible cause of progressive visual disturbance and a potential risk of ACA infarction in a child with a craniopharyngioma.
authors.affiliation: Department of Neurosurgery, Higashiosaka City General Hospital, Higashiosaka, Japan. hyokota0001 @ gmail.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokota
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Nishioka
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Seiji
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D020771:Anterior Cerebral Artery / Q000002:abnormalities* / Q000601:surgery; D001766:Blindness / Q000209:etiology* / Q000601:surgery; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000175:diagnosis* / Q000601:surgery; D019299:Decompression, Surgical; D018450:Disease Progression; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D009897:Optic Chiasm / Q000601:surgery; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000601:surgery