An atypical visual presentation in a setting of a critically thinned optic nerve compressed between a Rathke's cleft cyst and anterior cerebral artery: illustrative case.

Journal of neurosurgery. Case lessons Pub Date : 2025-08-11 DOI:10.3171/CASE25334

Rayford Hazunga, Satoru Oshino, Yuji Onoda, Hidekazu Nakata, Noriyuki Kijima, Haruhiko Kishima

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Abstract

Background: A superior temporal visual field defect is the first sign of a chiasmal disorder by a suprasellar mass lesion. Some lesions may present with atypical visual deficits.

Observations: The authors present the case of a 71-year-old woman who presented with inferior temporal hemianopia of the left eye in the setting of a Rathke's cleft cyst (RCC). During transsphenoidal surgery, they found the optic nerve was compressed by the anterior cerebral artery (ACA) and appeared translucent. Preoperative MRI revealed that the left optic nerve was compressed between the ACA and RCC, corresponding to surgical findings. Postoperative imaging showed optic nerve thinning and notching on its surface.

Lessons: In patients with visual field impairment by sellar mass lesion, attention should be paid not only to upward compression by the mass lesion but also to downward compression by the ACA. https://thejns.org/doi/10.3171/CASE25334.

查看原文本刊更多论文

在Rathke裂隙囊肿和大脑前动脉之间出现视神经严重变薄的不典型视觉表现：说明性病例。

背景：颞上视野缺损是鞍上肿块病变引起的交叉障碍的第一个征象。有些病变可能表现为非典型的视力缺陷。观察：作者提出的情况下，一个71岁的妇女谁提出了下颞偏盲的左眼在设置拉特克的裂隙囊肿（RCC）。在经蝶窦手术中，他们发现视神经被大脑前动脉（ACA）压迫，呈半透明状。术前MRI显示左视神经在ACA和RCC之间受压，与手术结果一致。术后影像学显示视神经变薄，表面有切痕。经验教训：鞍区肿块病变导致视野损害的患者，除了肿块向上压迫外，还要注意ACA向下压迫。https://thejns.org/doi/10.3171/CASE25334。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of neurosurgery. Case lessons

CiteScore

0.40

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0.00%

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