Opto-Chiasmatic Arachnoiditis in the Young

Abstract

14 young patients, operated upon for opto-chiasmatic arachnoiditis by craniotomy are presented. 2 main etiopathogenetic forms (and their respective clinical equivalents) of the disease could be recognized. Only 1 postoperative death occurred, in a patient with a dominant clinical picture of intracranial hypertension. Results of surgery (craniotomy and lysis of adhesions) could be distinguished as positive (functional improvement) in 5 cases, indifferent or negative in the others, with a follow-up duration of up to 23 years. The role of the diagnostic value of the pneumoencephalogram as a basis for surgical indication is discussed: it is felt that this examination, when reported as negative, is not of sufficient value to rule out the diagnosis, which must essentially rely upon clinical data.

Delayed visual loss from optochiasmatic arachnoiditis after resection of craniopharyngioma

“…2,3,6,8,9,12 When the optic nerve is involved, this entity presents with gradual and progressive monocular concentric VF reduction. The gradual VF reduction may subsequently occur in the other eye.…”

“…The gradual VF reduction may subsequently occur in the other eye. 2,[5][6][7][8][9]12 The process can also be bilateral and simultaneous. Additionally, loss of visual acuity can present itself in the forms described for VF loss.…”

“…Factors determining the degree of recovery are not known. 1,2,[6][7][8][9]12,15 This case describes a young boy who presented with postoperative optochiasmatic arachnoiditis following resection of a 3-cm craniopharyngioma in infancy. Symptoms due to the arachnoiditis followed a latent interval of 11 years.…”