Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study documents the results of standardized A-scan examinations performed in 59 cases of optic nerve lesions (15 perioptic meningiomas, four gliomas, 15 acute neuritides, ten optic atrophies, five ischemic optic neuropathies, five acute central retinal vein occlusions, five traumatic optic neuropathies), as compared with 73 normal optic nerves. Analysis included the assessment of reflectivity (spike height) and nerve width (maximal diameter) with the patient fixating in primary gaze and 30 degrees of eccentric gaze; measurements were obtained from the anterior one third and posterior one third of the optic nerves. Increased nerve diameters could be distinguished as noncompressible (a negative 30 degrees test) when due to tumor, or compressible (a positive 30 degrees test) when due to increased subarachnoid fluid, as exemplified by inflammatory optic neuritis or traumatic neuropathy. Moreover, reflectivity patterns regularly differentiated meningioma (medium reflectivity) from optic glioma (low reflectivity). Neither ischemic neuropathy nor vein occlusion altered optic nerve diameter. These results indicate that echographically defined optic nerve diameter, compressibility in eccentric gaze, and reflectivity patterns can be used to effectively distinguish among causes of chronic optic atrophy (tumor vs remote neuropathy) and disc edema (tumor vs neuritis vs ischemic neuropathy).
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PMID:Standardized A-scan echography in optic nerve disease. 330 21

Three cases of chiasmal optic neuritis are described with bitemporal visual field loss and enlargement of the optic chiasm as demonstrated by computed tomography (CT). Exploratory craniotomies were performed in two of the patients, but no tumor was found. After corticosteroid treatment, all three patients experienced virtually complete restoration of normal vision. Although the CT presentation in these patients was indistinguishable from that of a chiasmal glioma, the clinical presentation of acute visual loss in an older child or adult should suggest chiasmal optic neuritis. A period of observation, with or without a trial of corticosteroids, might permit the latter diagnosis and obviate exploratory craniotomy.
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PMID:Computed tomography of chiasmal optic neuritis. 641 Aug 61

A 55-year-old African-American man developed progressive unilateral optic neuropathy and periocular pain. MRI showed thickening and enhancement of the mid-orbital segment of the ipsilateral optic nerve. Optic neuritis was diagnosed, and he was treated with corticosteroids without improvement. After being lost to follow-up, he returned with worsening vision in the affected eye, aggravated pain, and proptosis. MRI now showed thickening and enhancement of the entire orbital and intracranial segments of the optic nerve. Because the patient had no light perception vision in that eye and a malignant glioma was suspected, he underwent optic nerve biopsy that revealed non-caseating granulomas throughout the optic nerve tissue. CT body imaging failed to disclose other evidence of sarcoidosis. Neurosarcoidosis limited to the optic nerve is rare but should always be suspected in such circumstances. An exhaustive effort to find extracranial evidence for this diagnosis should be undertaken before resorting to optic nerve biopsy.
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PMID:Neurosarcoidosis mimicking a malignant optic glioma. 1876 87

We report a 63-year-old, previously healthy female patient with glioblastoma multiforme of the optic nerve and chiasm presenting as acute anterior optic neuropathy. She presented with a 3-week history of progressively increasing headaches, retrobulbar pain, rapidly progressive visual loss in the right eye and blurred vision in the left eye. Early clinical examination revealed right optic disc swelling and she was initially diagnosed with demyelinating optic neuritis. Her clinical course deteriorated with total visual loss in the right eye and progressive visual loss in the left eye despite treatment with intravenous (IV) methylprednisone and IV immunoglobulins. MRI revealed enhancement of the right optic nerve and optic chiasm, with multiple periventricular hyperintense foci. Six weeks later, the patient presented with left facial palsy and left hemiparesis. Follow-up MRI showed multiple enhancing lesions in addition to the previous lesions involving right lentiform and right thalamic nucleus, right cerebral peduncle, right temporal and parietal lobes. Although the optic nerve biopsy was inconclusive, the brain biopsy revealed glioblastoma multiforme. This report demonstrated that malignant glioma of adulthood may be multicentric and may mimic optic neuritis clinically, which might help explain the difficulties in diagnosis.
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PMID:Multifocal malignant optic glioma of adulthood presenting as acute anterior optic neuropathy. 2155 Feb 55

Magnetic resonance imaging is the modality of choice to investigate patients with central nervous system diseases. In patients with optic neuritis, early MRI allows positive and differential diagnosis, and gives arguments for prognosis. The technique should be adapted for the exploration of visual pathways. Inflammatory optic neuritis is characterized by an early signal abnormality within the optic nerve, whereas optic nerve MRI is normal in the early phase of ischemic optic neuropathy. MRI also detects compressive and infiltrative lesions. Meningiomas are characterized by abnormalities within the peri-optical spaces, whereas a global increase in the size of the optic nerve is in favor of a glioma.
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PMID:Contribution of imaging to the diagnosis of optic neuropathies. 2298 Dec 71

Malignant optic glioma presents a clinical and diagnostic challenge, as early imaging findings overlap with other more common causes of optic nerve enhancement and enlargement, potentially leading to delay in diagnosis. This rare diagnosis carries an extremely poor prognosis, with death usually occurring within 1 year. We present a case of malignant optic glioma that was initially diagnosed as optic neuritis and central retinal vein occlusion, and we emphasize the importance of serial imaging and definitive biopsy to promote early diagnosis and treatment of this entity.
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PMID:Malignant optic glioma masked by suspected optic neuritis and central retinal vein occlusion. 3045 Jan 48