Just the Two of Us

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Identifier walsh_2019_s3_c5-slides
Title Just the Two of Us
Creator Dan Milea, MD, PhD
Subject Tumor; Optic Neuropathy; Metastatic Carcinoma; Optic Nerve; Compressive Optic Neuropathy
Description A 63-year-old female patient of Chinese ethnicity was referred for unexplained visual loss in her right eye, discovered incidentally 1 month before presentation. Her past medical history revealed quiescent asthma and a benign cyst in the left lung, excised 27 years earlier. The patient had no vascular risk factors and was not smoking. On examination, best-corrected vision was counting fingers in the right eye and 6/7.5 in the left eye, associated with severe color vision loss in the right eye. There was a dense right relative afferent pupillary defect, but the remainder of the neuro-ophthalmic examination was normal, including fundoscopy, ocular motility and other cranial nerves functions. There was a dense visual field defect in the right eye and a Cirrus OCT disclosed normal retinal nerve fiber layer thickness in both eyes. The presumptive diagnosis was unexplained right retrobulbar optic neuropathy. A brain MRI disclosed an enhancing ; mass involving the anterior right clivus and apex, infiltrating the ipsilateral cavernous sinus, highly suggestive of meningioma. Excision of the tumor was decided by the neurosurgical team, and pathology confirmed a WHO Grade III parapapillary chordoid meningioma. Postoperatively, the patient had an ispilateral iatrogenic pupil-involving 3rd nerve palsy, an ipsilateral 4th nerve palsy and developed a right soleal vein thrombosis, treated symptomatically. However, the patient's main post-operative complaint was persistent coughing.
Date 2019-03
Language eng
Format application/pdf
Source 2019 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS 2019: Frank B. Walsh Session 3
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Rights Management Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6sf7dfk
Contributor Primary Dan Milea, MD, PhD
Setname ehsl_novel_fbw
ID 1431991
Reference URL https://collections.lib.utah.edu/ark:/87278/s6sf7dfk
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