title: Visual improvement and pain resolution in traumatic optic nerve sheath meningocele treated by optic nerve sheath fenestration.
abstract: OBJECTIVE
  There is no consensus as to the optimum treatment for traumatic optic neuropathy (TON). The decision to intervene medically or surgically, or simply observe was recommended to be on an individual basis. The purpose of this study is to test whether optic nerve sheath fenestration (ONSF) could improve vision in patients with traumatic optic nerve sheath meningocele, although it was reported to be effective in patients with traumatic optic nerve sheath hematoma.
  
  
  METHODS
  ONSF was performed on two traumatic patients with dilated optic nerve sheath from MRI.
  
  
  RESULTS
  Both patients initially suspected as traumatic optic nerve sheath hematoma were diagnosed as traumatic optic nerve sheath meningocele by intraoperative findings of the enlarged optic nerve sheath and clear fluid drained without evidence of blood in the subdural space. Moreover, significant orbit/head pain resolution and visual improvement within a week after ONSF was found.
  
  
  CONCLUSIONS
  When TON presents with an enlarged optic nerve/sheath on CT or MRI with visual loss, an optic nerve sheath meningocele should be considered with the consideration that ONSF may benefit both visual acuity and post-traumatic pain, if present.
authors.affiliation: Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China Laboratory Animal Institute, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Hui
authors.affiliation: Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Xiaoyun
authors.affiliation: Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yi
authors.affiliation: Emergency Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Ningbo
authors.affiliation: Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Xizhong
authors.affiliation: Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Shaowei
authors.affiliation: Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Ophthalmology (East Area), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Maozhu
authors.affiliation: Department of Ophthalmology (East Area), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Ma
authors.initials: M
authors.lastname: Wubo
authors.affiliation: Department of Ophthalmology (East Area), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Xuefei
authors.affiliation: Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Lai
authors.initials: L
authors.lastname: Li
authors.affiliation: Neurosurgery Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Tan
authors.initials: T
authors.lastname: Haibin
authors.affiliation: Laboratory Animal Institute, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Daiwen
authors.affiliation: Neurosurgery Department, Lu Zhou Medical College, Luzhou, Sichuan, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yong
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000150:complications*; D008875:Middle Aged; D009186:Myelin Sheath; D009900:Optic Nerve / Q000502:physiology / Q000601:surgery; D020221:Optic Nerve Injuries / Q000150:complications*; D010146:Pain / Q000209:etiology* / Q000601:surgery*; D015898:Tomography Scanners, X-Ray Computed; D014786:Vision Disorders / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult
keywords: Traumatic optic neuropathy; head/orbital pain; optic nerve sheath fenestration (ONSF); optic nerve sheath meningocele