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Transient visual obscurations, without papilloedema

D Hilton-Jones, J R Ponsford, N Graham

    Journal of Neurology, Neurosurgery, and Psychiatry
    |September 1, 1982
    PubMed
    Summary
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    Frontal tumors can cause visual disturbances and gait issues without typical papilledema. Herniation compressing the posterior cerebral artery may explain intermittent occipital lobe ischemia.

    Area of Science:

    • Neurology
    • Neuro-oncology
    • Vascular Neurology

    Background:

    • Space-occupying lesions in the frontal lobe can present atypically.
    • Papilledema is a common sign of increased intracranial pressure, but its absence does not rule out serious pathology.

    Observation:

    • Two cases of frontal, space-occupying tumors were identified.
    • Patients presented with stereotyped visual disturbances, orbital headache, neck pain, and gait unsteadiness.
    • No papilledema was observed in either case.

    Findings:

    • The clinical presentation suggests intermittent occipital lobe ischemia.
    • This ischemia is likely caused by compression of the posterior cerebral artery.
    • Brain herniation against the tentorium due to the tumor appears to be the mechanism.

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    Implications:

    • This highlights the importance of considering atypical presentations of brain tumors.
    • It underscores the potential for posterior cerebral artery compromise in frontal mass lesions.
    • Early diagnosis and intervention are crucial for managing such complex neurological conditions.