Visual Field Defects Associated With Cerebellar Tumors

Neuro-ophthalmological complications of enlargement of the third ventricle.

“…Bitemporal hemianopia resulting from bulging of the floor of the third ventricle in a patient with hydrocephalus was first reported by Weber (1906), and individual patients have subsequently been reported by Oppenheim (1911), Wilbrand and Saenger (1913), Learmonth et al (1931), Sinclair and Dott (1931), Wohlwill (1931, Wagener andCusick (1937), Weinberger andWebster (1941), and Walsh and Hoyt (1969). A neoplasm in the posterior fossa (usually cerebellar) was the underlying lesion in most of these patients.…”

“…Wagener and Cusick (1937) described 1 patient with an incongruous homonymous hemianopia due to a posterior fossa lesion. Four patients each with homonymous hemianopia and a cerebellar tumour were reported by Weinberger and Webster (1941). These visual field defects may be accounted for by either of 2 mechanisms.…”

“…The first suggests that downward displacement of a distended third ventricle against a prefixed chiasma may result in optic tract compression. An alternative explanation proposes that the distended third ventricle ventrally displaces the optic chiasma and stretches the optic tract over the posterior communicating artery (Fay and Grant, 1923;Weinberger and Webster, 1941;Hughes, 1946). Binasal hemianopia has been described as a feature of third ventricular distension (Cushing and Walker, 1912).…”

“…Posterior fossa lesions may produce a false localising chiasmal syndrome with bitemporal hemianopia and bilateral optic atrophy, secondary to an enlarged third ventricle acting as a suprasellar mass (Weber, 1906;Oppenheim, 1911;Wilbrand and Saenger, 1913;Learmonth, 1931;Sinclair and Dott, 1931;Wohlwill, 1931;Wagener and Cusick, 1937;Weinberger and Webster, 1941;Walsh and Hoyt, 1969). Unilateral optic nerve dysfunction, infranuclear motility disturbances, unilateral proptosis, and the Sylvian aqueduct syndrome produced by internal hydrocephalus are rare (Lassman et al, 1960;Lerner et al, 1969;Swash, 1974;Shapiro et al, 1976).…”

Some Observations on the Visual Fields in Hydrocephalus

“…Wildbrand and Saengar (1913, p. 240) .discuss in detail the pathological aspects of these cases, but only reproduce one visual field which shows bitemporal hemianopic central scotomata resulting from hydrocephalus. More recently, temporal defects have been recorded by Sinclair and Dott (1931), and homonymous, temporal and binasal defects have been published by Wagener and Cusick (1937) and by Weinberger and Webster (1941). The presence of binasal defects due to displacement of the optic nerves or chiasma by the distended third ventricle against the carotid arteries has been discussed by Cushing and Walker (1912).…”