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Sub-acute blindness in a patient with a temporal lobe astrocytoma

Ajai Seth1, Susan Short, Fion Bremner

  • 1Queen Elizabeth Hospital, 12 Oakley Avenue, Barking, London IG11 9JD, UK.

BMJ Case Reports
|June 22, 2011
PubMed

Insights

A man experienced rapid vision loss due to a glioblastoma multiforme. Despite surgery, papilledema persisted, suggesting non-compressive causes for visual impairment in brain tumor patients.

Area of Science:

  • Neuro-oncology
  • Ophthalmology
  • Neurology

Background:

  • Glioblastoma multiforme (WHO grade 4 astrocytoma) can present with visual disturbances.
  • Papilledema is a known complication of intracranial tumors.
  • Visual loss in brain tumor patients can have multifactorial causes.

Purpose of the Study:

  • To report an unusual case of sub-acute visual loss in a patient with glioblastoma.
  • To explore potential mechanisms of visual loss unrelated to direct tumor compression.
  • To suggest preventative strategies for visual impairment in similar cases.

Main Methods:

  • Case report of a middle-aged male patient.
  • Clinical presentation of sub-acute visual loss over 4 weeks.
  • Diagnosis of right temporal lobe glioblastoma multiforme.
  • Monitoring of papilledema before and after debulking surgery.
  • Radiological assessment for direct visual pathway involvement.

Main Results:

  • The patient developed blindness over 4 weeks.
  • Chronic papilledema persisted post-surgery without direct radiological evidence of visual pathway compression.
  • The visual loss was sub-acute on a chronic presentation.

Conclusions:

  • Visual loss in glioblastoma patients may occur through mechanisms other than direct compression or infiltration.
  • Non-compressive causes, potentially related to papilledema or treatment effects, should be considered.
  • Further investigation into preventative measures for visual impairment in brain tumor patients is warranted.

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