Intracranial sarcoidosis with optic tract and temporal lobe involvement

Area of Science:

• Neurology
• Ophthalmology
• Radiology

Background:

• Sarcoidosis is a systemic inflammatory disease that can affect the central nervous system, presenting with diverse neurological deficits.
• Intracranial sarcoidosis, though rare, requires prompt diagnosis and management to prevent irreversible neurological damage.

Observation:

• A 23-year-old male presented with a right homonymous hemianopic visual field defect, indicating a potential neurological issue.
• Radiological imaging revealed bilateral hilar and paratracheal adenopathy, consistent with pulmonary sarcoidosis.
• A large intracranial lesion was identified in the suprasellar cistern, extending into the left temporal lobe and affecting the optic tract.

Findings:

• A mediastinal lymph node biopsy confirmed sarcoidosis.
• Intensive corticosteroid therapy was initiated for the patient.
• The treatment resulted in visual restoration and significant improvement in the visual field defect.

Implications:

• Corticosteroid therapy effectively managed intracranial sarcoidosis, leading to lesion resolution and improved neurological function.
• This case highlights the importance of considering sarcoidosis in the differential diagnosis of unexplained visual field defects.
• Prompt diagnosis and treatment of neurosarcoidosis can prevent long-term visual and neurological sequelae.