Identifier |
walsh_2015_s4_c5-1 |
Title |
Nobody's Perfect |
Creator |
Alexander Ksendzovsky, Steven A. Newman, MD, University of Virginia School of Medicine |
Subject |
Pilocytic Astrocytoma, Leptomeningeal Meningioma, Childhood Brain Tumor |
History |
In June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1 ½ she had developed headaches and was found to have a posterior fossa tumor. In El Salvador she was treated with shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwent a shunt revision at age 2 ½. Near vision was 20/20 OU with arcuate visual field defects, no afferent pupillary defect, normal motility, and normal discs including OCT. She did have an MRI which showed some likely post radiation changes, but a negative spinal MRI. On June 19, 2007 a repeat MRI scan, however, demonstrated a lesion at the L1 level. In March of 2006, a 29 year old patient was referred for a 6 month history of problems with his vision, and two weeks of headaches characterized as steady, and unassociated with nausea or vomiting. Visual acuity was correctible to 20/20 and 20/25. Visual fields demonstrated a bitemporal superior visual field defect. He had evidence of a 0.6 log unit left afferent pupillary defect. There were full ductions and versions and 100 seconds of stereopsis. His past medical history was remarkable for an incomplete form of osteogenesis imperfecta. MRI scan showed evidence of a sellar and suprasellar enhancing mass. A meningioma was suspected. A spinal MRI scan, however, demonstrated evidence of lumbar enhancement. CSF analysis was unremarkable. |
Disease/Diagnosis |
Leptomeningeal spread of pilocytic astrocytoma. |
Date |
2015-02 |
References |
1. Buschmann U, Gers B, Hilderbrandt G: Piolcytic astrocytomas with leptomeningeal dissemination: biological behavior, clinical course, and therapeutical options. Childs Nerv Syst 2003; 19: 298-304. 2. Bruggers CS, Friedman HS, Philips PC, Wiener MD et al: Leptomeningeal dissemination of optic pathway glioma in three children. Am J Ophthalmol 1991; 111: 719-723. 3. Mishima K. Nakamura M. Nakamura H. Nakamura O. et al: Leptomeningeal dissemination of cerebellar pilocytic astrocytoma. Case Report. J Neurosurg 1992; 77: 788-791. 4. Zorlu F. Selek U. Akyuz C. Ozturk A. et al: Spinal seeding of a pilocytic astrocytoma following multiple subtotal resections. Pediatr Neurosurg 2005; 41: 248-252. 5. Kocka W. Kalff R. Reinhardt V. Grote W. Hilke J: Spinal metastasis of pilocytic astrocytomas of the chiasma opticum. Childs Nerv Syst 1989; 5: 118-120. |
Language |
eng |
Format |
video/mp4 |
Type |
Image/MovingImage |
Source |
47th Annual Frank Walsh Society Meeting |
Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6240 |
Rights Management |
Copyright 2015. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
ARK |
ark:/87278/s6k67fq9 |
Setname |
ehsl_novel_fbw |
ID |
179286 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6k67fq9 |