'X' Marks the Spot

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Identifier walsh_2021_s1_c3-video
Title 'X' Marks the Spot
Creator Luis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy Greenlee
Subject Optic Chiasm; Intracranial Tumors; Magnetic Resonance Imaging (MRI); Vision Loss Binocular
History This 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symptoms. He denied galactorrhea, fatigue, and abdominal pain. On exam, his visual acuity was 20/125 OD and 20/50 OS. He had incomplete atypical bitemporal defects that respected the vertical meridian and pallor of both optic nerves, right more than left. Magnetic resonance imaging (MRI) of the brain showed an enlarged optic chiasm and a hyperintense left frontal periventricular lesion that was abutting the genu of the corpus callosum. Both lesions showed mild contrast enhancement. The differential diagnosis included a primary intrinsic chiasmal glioma versus an inflammatory etiology. An extensive infectious, inflammatory, and rheumatologic work-up was unrevealing. Cerebrospinal fluid (CSF) evaluation showed a mild lymphocytic pleocytosis (11/mL) and mildly increased protein concentration (54 mg/dL). The CSF showed 3 oligoclonal bands. CSF cytology and cultures were negative. Based on these findings, he received a 1-month course of high dose steroid treatment without clinical improvement and further visual loss in both eyes. Repeat MRI brain showed no radiological improvement. At this point, the patient started complaining of increased thirst. A diagnostic procedure was performed.
Relation is Part of NANOS Annual Meeting 2021: Walsh Session I
Contributor Primary Luis Andre Leal Ferman, MD, FRCPC
Contributor Secondary Leslie Bruch, John Buatti, Jeremy Greenlee
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2021-02
Type Image/MovingImage
Format video/mp4
Source 53rd Annual Frank Walsh Society Meeting
Rights Management Copyright 2021. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6674ckg
Setname ehsl_novel_fbw
Date Created 2021-05-21
Date Modified 2021-05-21
ID 1697338
Reference URL https://collections.lib.utah.edu/ark:/87278/s6674ckg