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Diagnosis of optic nerve sheath meningioma during optic nerve sheath decompression

机译：视神经鞘减压期间视神经鞘脑膜瘤的诊断

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Optic nerve sheath meningioma (ONSM) is typically diagnosed based on clinical suspicion and imaging characteristics and is most often treated with radiation. Historically, biopsy, optic nerve sheath decompression, and debulking surgeries have been avoided for fear of optic nerve vascular disruption and tumor spread into the orbit. This is a case of a 48-year-otd man who presented with unilateral optic disc edema, declining visual acuity, and a visual field defect. Despite an initial improvement with acetazoiamide, his vision subsequently worsened. With an elevated lumbar puncture opening pressure and imaging showing right optic nerve sheath enhancement, the differential diagnosis included ONSM, perineuritis and idiopathic intracrania! hypertension (IIH). Optic nerve sheath decompression (ONSD) with biopsy was performed, simultaneously decompressing the nerve and yielding a sample for pathologic analysis. A pathologic diagnosis of ONSM was made and treatment with radiation was subsequently initiated, but vision began to improve after the surgical decompression alone.
机译：视神经护套脑膜瘤（ONSM）通常根据临床怀疑和成像特性诊断，并且最常用辐射治疗。历史上，为了恐惧视神经血管破坏和肿瘤进入轨道，已经避免了活组织检查，视神经护套减压和剥离手术。这是一个48岁的OTD男子，呈现单方面视盘水晶水肿，视力下降和视野缺陷。尽管对乙酰唑氧化物进行了初步改善，但他的视力随后恶化。随着腰部穿刺开启压力和成像升高，显示出右视神经鞘增强，差异诊断包括持续的onsm，perineuritis和特发性颅内！高血压（IIH）。具有活组织检查的视神经鞘减压（ONSD），同时减压神经并产生用于病理分析的样品。随后启动了对onsm进行了病理诊断，并进行了辐射治疗，但是在单独的外科减压后，视觉开始改善。

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