Abstract
Introduction: Optic nerve sheath meningiomas and intracavernous arachnoid cysts are both fairly rare conditions, and to the best of our knowledge, have not been previously reported to co-occur in the same patient. Both can cause diplopia, but only ONSMs have been documented to demonstrate progressive worsening of ocular motility. Case Report: A 67-year-old woman with blur and diplopia demonstrated a right optic neuropathy and limited ductions bilaterally. Neuroimaging revealed a right optic nerve sheath meningioma and left intracavernous arachnoid cyst. She was conservatively managed with neurosurgical surveillance for 1.5 years, until her diplopia worsened. Ocular motility re-evaluation demonstrated a worsening left abduction deficit, suggesting interval change of the intracavernous cyst, rather than the meningioma. Conclusion: There are only a few reported cases of cranial nerve VI palsy secondary to a cavernous sinus arachnoid cyst. However, this is the first reported case in a patient with a concurrent optic nerve sheath meningioma, and the first case demonstrating progressive worsening of a sixth cranial nerve palsy from an intracavernous arachnoid cyst. Determining which comorbidity caused worsening of symptoms played a critical role in the management of this patient.
Original language | English (US) |
---|---|
Pages (from-to) | NP86-NP89 |
Journal | European journal of ophthalmology |
Volume | 30 |
Issue number | 5 |
DOIs | |
State | Published - Sep 1 2020 |
Externally published | Yes |
Keywords
- Arachnoid cyst
- cavernous sinus
- diplopia
- optic nerve sheath meningioma
- optic neuropathy
- sixth cranial nerve palsy
ASJC Scopus subject areas
- Ophthalmology