Cystic Optic Chiasm Lesion: Atypical Magnetic Resonance Imaging Findings

Abstract

Intrinsic cystic lesions in the optic chiasm are an uncommon cause of bitemporal hemianopia compared with compressive lesions extrinsic to the chiasm. A 40-year-old man presented with difficulty driving. Clinical assessment revealed a bitemporal hemianopia. Magnetic resonance imaging showed an unusual cystic appearance of the chiasm. The appearance was felt to be most likely secondary to previous infective or inflammatory disease, but biopsy was not undertaken given the very significant risk of further visual loss.

BRAF V600E-Mutated Ganglioglioma of the Optic Pathway: A Case Report and Review of the Literature

“…The lesions occasionally can enhance after contrast administration and in younger patients often contain cystic components (7). If cystic components are noted on imaging, other cystic lesions of the optic pathways including arachnoid cysts, pilocytic astrocytomas, or lesions from previous inflammation or infection may be considered (31).…”