Is endoscopic optic nerve decompression useful in cases of optic neuropathy secondary to pachymeningitis?

IF 1.5 4区 医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2024-12-07 DOI:10.1016/j.neuchi.2024.101618
Jonathan G F Smith, Caroline P Smith, Philip Weir, Brendan C Hanna
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Abstract

This case reports the outcome of endoscopic optic nerve decompression in a rare case of idiopathic pachymeningitis in a patient solely reliant on the affected eye. A 70 year old man with complete blindness in his left eye presented with deterioration of vision in his right eye. An MRI head and orbits was suggestive of idiopathic pachymeningitis extending into the right orbital apex, causing a compressive optic neuropathy. He subsequently underwent endoscopic optic nerve compression. Visual acuity and colour vision were measured pre-operatively, and at 6 weeks and one year post operatively. Pre-operative visual acuity was measured at 6/9, compared to 6/9 at 6 weeks post operatively and 6/60 at one year. Colour vision was measured at 0/17 pre-operatively and did not improve post-. We report a rare case of optic neuropathy secondary to pachymeningitis, in which endoscopic nerve decompression did not offer the expected benefit of halting visual deterioration.

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内窥镜视神经减压术对继发于厚性脑膜炎的视神经病变有用吗?
本病例报告的结果内镜视神经减压在一个罕见的病例特发性厚性脑膜炎的病人完全依赖于受影响的眼睛。70岁男性,左眼完全失明,右眼视力减退。头部和眼眶MRI提示特发性厚性脑膜炎延伸至右眼眶尖,引起压缩性视神经病变。随后行内窥镜视神经压迫术。分别于术前、术后6周和1年测量视敏度和色觉。术前视力为6/9,术后6周视力为6/9,1年后视力为6/60。术前色觉评分为0/17,术后无明显改善。我们报告一个罕见的视神经病变继发于厚性脑膜炎的病例,在这个病例中,内窥镜神经减压术并没有提供预期的停止视力恶化的好处。
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来源期刊
Neurochirurgie
Neurochirurgie 医学-临床神经学
CiteScore
2.70
自引率
6.20%
发文量
100
审稿时长
29 days
期刊介绍: Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.
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