Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Bilateral Cortical Blindness Caused by Tentorial Herniation due to Brain Tumor

  • Jeon, Jee-Ho (Departments of Neurosurgery, College of Medicine, Hallym University) ;
  • Hwang, Hyung-Sik (Departments of Neurosurgery, College of Medicine, Hallym University) ;
  • Moon, Seung-Myung (Departments of Neurosurgery, College of Medicine, Hallym University) ;
  • Choi, Sun-Kil (Departments of Neurosurgery, College of Medicine, Hallym University)
  • Published : 2007.06.30
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Abstract

Two patients, one with glioblastoma multiforme [GM] in the right thalamus and the other with meningioma at the right frontal convexity, had suffered bilateral cortical blindness after transtentorial herniation. On one of those patients, bilateral cortical blindness had occurred due to acute obstructive hydrocephalus caused by GM and on the other patient, cortical blindness had developed after acute hemorrhage from meningioma. Bilateral occipital lobes of those patients showed signal change on the brain magnetic resonance image [MRI]. There were no ophthalmologic abnormalities on fundoscopy and ophthalmologic examination. After recovery of consciousness, cortical blindness was detected in both patients, and during gradual recovery period, visual function was slowly recovered. The pattern of visual evoked potential [VEP] at 7 weeks and 12 weeks after herniation was normalized gradually. Cortical blindness due to herniation was reversible, even though the high signals of bilateral visual cortex still existed on MRI 16 month later in case 2.

Keywords

References

  1. Aldrich MS, Alessi AG, Beck RW, Gilman S : Cortical blindness : Etiology, diagnosis and prognosis. Ann Neurol 21 : 149-158, 1987 https://doi.org/10.1002/ana.410210207
  2. Antonellis J, Kostopoulos K, Rambaouni A, Margaris N, Kranidis A, Salahas A, et al : Cortical blindness following coronary arteriography : a rare but self-cured complication. Two case reports. Angiology 47 : 803-806, 1996 https://doi.org/10.1177/000331979604700808
  3. Bergman DS : Cerebral blindness : an analysis of twelve cases, with special reference to the electroencephalogram and patterns of recovery. Arch Neurol Psychiatry 78 : 568-584, 1957 https://doi.org/10.1001/archneurpsyc.1957.02330420028004
  4. Eldridge PR, Punt JA : Transient traumatic cortical blindness in children. Lancet 1 : 815-816, 1988
  5. Good WV : Development of a quantitative method to measure vision in children with chronic cortical visual impairment. Trans Am Ophthalmol Soc 99 : 253-269, 2001
  6. Groenendaal F, van Hof-van Duin J : Visual deficits and improvements in children after perinatal hypoxia. J Vis Impair Blind 86 : 215-218, 1992
  7. Hoyt WF : Vascular lesions of the visual cortex with brain herniation through the tentorial incisura : Neuroophthalmologic considerations. Arch Ophthalmol 64 : 74-87, 1960
  8. Jackson A, Stewart G, Wood A, Gillespie JE : Transient global amnesia and cortical blindness after vertebral angiography : further evidence for the role of arterial spasm. AJNR Am J Neuroradiol 16 : 955-959, 1995
  9. Kamata J, Fukami K, Yoshida H, Mizunuma Y, Moriai N, Takino T, et al : Transient cortical blindness following bypass graft angiography. A case report. Angiology 46 : 937-946, 1995 https://doi.org/10.1177/000331979504601009
  10. Lindenberg R, Walsh FB : Vascular Compressions Involving Intracranial Visual Pathways. Trans Am Acad Ophthalmol Otolaryngol 68 : 677-694, 1964
  11. Makino A, Soga T, Obayashi M, Seo Y, Ebisutani D, Horie S, et al : Cortical blindness caused by acute general cerebral swelling. Surg Neurol 29 : 393-400, 1988 https://doi.org/10.1016/0090-3019(88)90048-1
  12. Maltby GL : Visual field changes and subdural hematomas. Surg Gynecol Obstet 74 : 496-498, 1942
  13. Meyer A : Herniation of the brain. Arch Neurol Psychiatry 4 : 387-400, 1920 https://doi.org/10.1001/archneurpsyc.1920.02180220036003
  14. Moore MT, Stern K : Vascular lesions in the brain-stem and occipital lobe occurring in association with brain tumors. Brain 61 : 70-98, 1938 https://doi.org/10.1093/brain/61.1.70
  15. Moseman CP, Shelton S : Permanent blindness as a complication of pregnancy induced hypertension. Obstet Gynecol 100 : 943-945, 2002 https://doi.org/10.1016/S0029-7844(02)02250-0
  16. Pevehouse BC, Bloom WH, McKissock W : Ophthalmologic aspects of diagnosis and localization of subdural hematoma : An analysis of 389 cases and review of the literature. Neurology (NY) 10 : 1037-1041, 1960 https://doi.org/10.1212/WNL.10.11.1037
  17. Pia HW : Die Schadigung des Hirnstammes bei den raumfordernden Prozessen des Gehirns. Acta Neurochir (Wien) Suppl 4 : 1-182, 1957
  18. Raj P, Moore PL, Henderson J, Macnamara M : Bilateral cortical blindness : an unusual complication following unilateral neck dissection. J Laryngol Otol 116 : 227-229, 2002
  19. Sato M, Tanaka S, Kohama A, Fujii C : Occipital lobe infarction caused by tentorial herniation. Neurosurgery 18 : 300-305, 1986 https://doi.org/10.1227/00006123-198603000-00007
  20. Shinoda J, Ajimi Y, Yamada M, Onozuka S : Cortical blindness during coil embolization of an unruptured intracranial aneurysm--case report. Neurol Med Chir (Tokyo) 44 : 416-419, 2004 https://doi.org/10.2176/nmc.44.416
  21. Sunderland S : The tentorial notch and complications produced by herniations of the brain through that aperture. Br J Surg 45 : 422-438, 1958 https://doi.org/10.1002/bjs.18004519306
  22. Yilmazlar S, Taskapilioglu O, Aksoy K : Transient Anton's syndrome : a presenting feature of acute epidural hematoma at the confluens sinuum. Pediatr Neurosurg 38 : 156-159, 2003 https://doi.org/10.1159/000068813