Unexplained loss of vision in a child: consider bilateral primary optic nerve sheath meningioma.
A 4-year-old girl gradually lost her vision to become practically blind at the age of 10 years. Examinations at several medical centers had been unable to establish an etiology. Traditional investigation using cerebral magnetic resonance imaging (MRI) initially showed normal results; however, later on it showed progressive atrophy of both optical nerves without recognizable cause. Subsequently, MRI including adequate orbital sequences, contrast-enhanced sequences, and fat suppression demonstrated bilateral primary optic nerve sheath meningioma, a rare but treatable tumor of childhood. The patient underwent neurosurgery and to date retains minimal vision. Adequate neuroradiological investigation of unexplained optic atrophy is advocated.
Department of Pediatrics, Clinic for Degenerative Brain Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Miriam
M
Nickel
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ulrike
U
Löbel
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Brigitte
B
Holst
Department of Neurological Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Gertrud
G
Kammler
Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jakob
J
Matschke
Department of Pediatrics, Clinic for Degenerative Brain Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Angela
A
Schulz
Department of Pediatrics, Clinic for Degenerative Brain Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Alfried
A
Kohlschütter
D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications*; D008579:Meningioma / Q000150:complications*; D019574:Optic Nerve Neoplasms / Q000150:complications*; D014786:Vision Disorders / Q000209:etiology*