Opto-chiasmatic arachnoiditis: A review of traditional neuroradiological diagnosis (82 cases, 1951–1976)

Abstract

A retrospective appraisal of traditional neuroradiological techniques (such as direct röntgenograms, cerebral angiography RISA-cisternography, and pneumo-cisterno-encephalography, as opposed to the "new" technique of computer-assisted tomography) was carried out in a series of 82 cases of opto-chiasmatic arachnoiditis, all surgically verified. It is concluded that none of these examinations can provide a reliable diagnosis of opto-chiasmatic arachnoiditis, which preoperatively can only be a tentative diagnosis that becomes final only when confirmed by surgical findings. In the presence of certain progressive neuro-ophthalmological symptoms and signs, a negative neuro-radiological investigation should not deter the neurosurgeon from exploring the chiasmatic region. Computer-assisted tomography, of which the authors have no personal experience in these cases, may hold the future answer to the diagnostic problem.

Opto-Chiasmatic Arachnoiditis in the Young

“…The gross surgical findings of adhesions in several hundred operations cannot be dismissed as phantasy, even though seldom supported by pathological and histological evidence in a condition that, serious as it may be for visual function, does not carry a high mortality rate. Such a demonstration, though rare, is however available [3,10,12,14,20,21]. It should also be borne in mind that histopathological confirmation was hard to obtain -at least in pre-microsurgical times -for even the thickest adhesions removed from a plastic-adhesive arachnoiditis change after dissection into flimsy strands and shreds, that go inevitably lost into the suction tube along w'ith the irrigating solution and the cerebrospinal lluid.…”

“…with 3 'false-negative'(cases 7,9, I4)and 1 'false-positive'(case4 )result. The pneumoencephalographic evidence considered as typical of OCA [12] was found in 7 cases (2. 4.…”

“…All patients having been admitted before the installation of our CT scanner (July 1978), their neuroradiologicai investigation w'as limited to traditional techniques [12], The carotid arteriogram showed, in patient 12. an outward angulation of the carotid syphon, later confirmed at surgery [11] or suggested, in patient 10. a temporal space-occupying lesion. A pneumocisterno-encephalogram and/or a ventriculogram were performed in all cases ( fig.…”

Historia biográfica de manuel balado: aportes al desarrollo de la neurocirugía mundial

“…A mediados del año 1937, publicó en Berlín, junto a Elizabeth Franke, su quinto libro "Das Corpus Geniculatum Externum Eine Anatomisch -Klinische Studie", de Editorial Julius Springer 35 y es el primero en describir la topografía de las cintillas ópticas, la vía visual y de los cuerpos geniculados. 36,37 El reconocimiento logrado le permitió desarrollar en forma incesante sus investigaciones, así como la formación de cirujanos neurológicos en el país, impulsando de esta manera la especialidad en América Latina.…”