Apoplectic optochiasmal syndrome due to intrinsic cavernous hemangioma. Case report

A 42-year-old man suffered from acute evolving visual loss after drinking alcohol. Consecutive visual field changes suggested a mass within the left optic nerve extending its compression across the chiasm and encroaching on the left optic tract. Computed tomography scanning and magnetic resonance imaging confirmed the presence of an overt hemorrhage, a real apoplectic event of cavernous hemangioma. Cavernous hemangiomas located within the intracranial optic nerve are few. Occult hemorrhage within the confines of the intrinsic vascular tumor resulted in acute visual changes in most reported cases. Overt hemorrhage with blood extravasation beyond the original confines of the intrinsic optochiasmal tumor are rarely reported in the literature. Herein, we report one such case. The clinical course and the predisposing factors are also discussed.