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Optic nerve arteriovenous malformation causing optic apoplexy: case report
Yoshihiro Muragaki1, Hiroshi Ujiie, Masayuki Ohno
1Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Japan. ymuragaki@nij.twmu.ac.jp
Neurosurgery
|September 18, 2002
Summary
Arteriovenous malformations (AVMs) are rare causes of optic nerve apoplexy. Magnetic resonance imaging aids in diagnosing optic nerve AVMs, with early surgery recommended for better recovery.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Surgery
Background:
- Optic pathway vascular malformations, such as arteriovenous malformations (AVMs), are exceptionally rare.
- Optic nerve AVMs are seldom reported, with only one pathologically confirmed case previously documented.
Observation:
- A 15-year-old female presented with sudden left visual disturbance.
- Magnetic resonance imaging (MRI) revealed left optic nerve swelling and intraorbital hemorrhage.
- Initial angiography failed to identify abnormal vasculature.
Findings:
- Surgical intervention involved hematoma evacuation and removal of abnormal vessels within the optic nerve.
- Pathological examination confirmed the lesion as an arteriovenous malformation (AVM).
- Post-surgery, visual acuity improved, but a left visual field defect persisted.
Implications:
- Optic nerve AVMs are a rare differential diagnosis for optic nerve apoplexy, alongside cavernous malformations and optic gliomas.
- T2-weighted MRI effectively visualizes optic nerve AVMs as tangled, low-intensity masses.
- Prompt surgical treatment is advised to facilitate rapid visual recovery in cases of optic nerve AVMs.