Summary
Diminishing right ocular visual acuity for three weeks in a 30 year old man was confirmed by examination. Bilateral scotomata and bitemporal hemiachromatopsia indicated a chiasmal lesion; reduced visual acuity and Marcus Gunn pupil of the right eye and left relative temporal hemianopia indicated asymmetric involvement. Erythrocytes in the CSF verified a suspected subarachnoid bleed; contrast-enhanced CAT scan demonstrated a suprasellar mass. A cystic, multiloculated, bluish mass distorted the right optic nerve, tract, and chiasm. A hematoma was evacuated and biopsy revealed a cavernous hemangioma of the right optic nerve. Post-operatively, visual acuity has recovered in the right eye but a left homonymous temporal hemianopia has developed.
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Manz, H.J., Klein, L.H., Fermaglich, J. et al. Cavernous hemangioma of optic chiasm, optic nerves and right optic tract. Virchows Arch. A Path. Anat. and Histol. 383, 225–231 (1979). https://doi.org/10.1007/BF01200902
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DOI: https://doi.org/10.1007/BF01200902