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Catalán-Coronado S, Parrado-Carrillo A, Nogués-Castell J, Rosinés-Fonoll J, Camós-Carreras A, Alcubierre R, Carrión-Donderis MT, Bernal-Morales C, Sánchez-Dalmau B. Case report: Bilateral optic nerve sheath meningocele: clinical aspects. FRONTIERS IN OPHTHALMOLOGY 2024; 4:1385485. [PMID: 38984125 PMCID: PMC11182330 DOI: 10.3389/fopht.2024.1385485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/17/2024] [Indexed: 07/11/2024]
Abstract
Optic nerve sheath meningocele is an enlargement of the sheath itself, consisting of a collection of cerebrospinal fluid along the perineural space. It should be considered primary if it is not associated with orbital-cerebral neoplasm or with cranio-orbital junction malformations. We report three cases of bilateral primary idiopathic optic nerve sheath meningocele, two of them with gradual vision loss. The first case presented a history of monocular blurred vision of the right eye and headache. It was initially treated with acetazolamide without any improvement, after which optic nerve sheath fenestration was required. The second case showed intermittent binocular diplopia with central 24-2 perimetry defects in the left eye. The third case was first presented as a subacute bilateral conjunctivitis with a suspected orbital pseudotumor. An incidental bilateral optic nerve sheath meningocele was found in the orbital imaging, being totally asymptomatic. In all the cases, orbital and cranial magnetic resonance with contrast and fat suppression was crucial in the diagnosis.
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Affiliation(s)
- Saray Catalán-Coronado
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | | | - Javier Nogués-Castell
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Josep Rosinés-Fonoll
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Anna Camós-Carreras
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Rafel Alcubierre
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | | | - Carolina Bernal-Morales
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Bernardo Sánchez-Dalmau
- Institut Clínic d'Oftalmologia, Hospital Clinic, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
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Gaudioso P, Biancoli E, Battistuzzi V, Concheri S, Saccardo T, Franchella S, Contro G, Taboni S, Zanoletti E, Causin F, Nico L, Gabrieli JD, Maroldi R, Nicolai P, Ferrari M. A Pathophysiological Approach to Spontaneous Orbital Meningoceles: Case Report and Systematic Review. J Pers Med 2024; 14:465. [PMID: 38793047 PMCID: PMC11122061 DOI: 10.3390/jpm14050465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/30/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Spontaneous orbital cephaloceles are a rare condition. The purpose of this study is to provide a description of a clinical case and to carry out a systematic literature review. METHODS A systematic review of the English literature published on the Pubmed, Scopus, and Web of Science databases was conducted, according to the PRISMA recommendations. RESULTS A 6-year-old patient was admitted for right otomastoiditis and thrombosis of the sigmoid and transverse sinuses, as well as the proximal portion of the internal jugular vein. Radiological examinations revealed a left orbital mass (22 × 14 mm) compatible with asymptomatic orbital meningocele (MC) herniated from the superior orbital fissure (SOF). The child underwent a right mastoidectomy. After the development of symptoms and signs of intracranial hypertension (ICH), endovascular thrombectomy and transverse sinus stenting were performed, with improvement of the clinical conditions and reduction of the orbital MC. The systematic literature review encompassed 29 publications on 43 patients with spontaneous orbital MC. In the majority of cases, surgery was the preferred treatment. CONCLUSIONS The present case report and systematic review highlight the importance of ICH investigation and a pathophysiological-oriented treatment approach. The experiences described in the literature are limited, making the collection of additional data paramount.
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Affiliation(s)
- Piergiorgio Gaudioso
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Oncology and Immunology (PhD Program), Department of Surgery Oncology and Gastroenterology (DiSCOG), University of Padova, 35128 Padova, Italy
| | - Elia Biancoli
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Veronica Battistuzzi
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Stefano Concheri
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Tommaso Saccardo
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Sebastiano Franchella
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Giacomo Contro
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Francesco Causin
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Lorena Nico
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Joseph Domenico Gabrieli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Roberto Maroldi
- Division of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy;
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G 2C4, Canada
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Bianconi A, Panico F, Lo Zito B, Do Trinh A, Cassoni P, Ricardi U, Garbossa D, Cofano F, Mantovani C, Bertero L. Understanding and Managing Pineal Parenchymal Tumors of Intermediate Differentiation: An In-Depth Exploration from Pathology to Adjuvant Therapies. J Clin Med 2024; 13:1266. [PMID: 38592098 PMCID: PMC10931940 DOI: 10.3390/jcm13051266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Pineal parenchymal cell tumors constitute a rare group of primary central nervous system neoplasms (less than 1%). Their classification, especially the intermediate subtype (PPTIDs), remains challenging. METHODS A literature review was conducted, navigating through anatomo-pathological, radiotherapy, and neurosurgical dimensions, aiming for a holistic understanding of these tumors. RESULTS PPTIDs, occupying an intermediate spectrum of malignancy, reveal diverse histological patterns, mitotic activity, and distinct methylation profiles. Surgical treatment is the gold standard, but when limited to partial removal, radiotherapy becomes crucial. While surgical approaches are standardized, due to the low prevalence of the pathology and absence of randomized prospective studies, there are no shared guidelines about radiation treatment modalities. CONCLUSION Surgical removal remains pivotal, demanding a personalized approach based on the tumor extension. This review underscores the considerable variability in treatment approaches and reported survival rates within the existing literature, emphasizing the need for ongoing research to better define optimal therapeutic strategies and prognostic factors for PPTIDs, aiming for further and more detailed stratification among them.
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Affiliation(s)
- Andrea Bianconi
- Neurosurgery Unit, Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Flavio Panico
- Neurosurgery Unit, Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Bruna Lo Zito
- Radiation Oncology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Andrea Do Trinh
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Umberto Ricardi
- Radiation Oncology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Diego Garbossa
- Neurosurgery Unit, Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Fabio Cofano
- Neurosurgery Unit, Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Cristina Mantovani
- Radiation Oncology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
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El-Masri S, Wilson M, Goh J, Sanfilippo P, Fok A, Hardy T, Chakrabarti R, Van Der Walt A. A 20-year multicentre retrospective review of optic nerve sheath fenestration outcomes. Ther Adv Neurol Disord 2023; 16:17562864231197994. [PMID: 37719666 PMCID: PMC10501074 DOI: 10.1177/17562864231197994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Background Optic nerve sheath fenestration (ONSF) longitudinal outcomes remain unclear and are vital in the assessment of vision failure in patients with raised intracranial pressure (ICP). Furthermore, limited observational data exists regarding its use in other causes of raised ICP. Objective To determine the efficacy and safety of ONSF for idiopathic intracranial hypertension (IIH), cerebral venous sinus thrombosis (CVST), and other indications. Method Multicentre study from a tertiary hospital and specialty eye referral hospital in Melbourne, Australia, from July 2000 to December 2020. A total of 116 eyes from 70 patients undergoing ONSF were retrospectively reviewed with patient demographics, surgery indications, visual acuity (VA), visual fields, fundus photos of optic discs, retinal nerve fibre layer (RNFL) thickness, average thickness of optic discs on optical coherence tomography (OCT), and complications recorded. Parametric tests were used to compare the treatment groups pre- and post-operatively. Results A total of 116 eyes from 70 patients underwent ONSF, which involved 92 eyes with IIH, 9 eyes with CVST, and 15 eyes with other aetiologies ('Other'). Post ONSF, there was a best corrected visual acuity (BCVA) improvement or stabilisation in 84% of patients in all groups, with 50% achieving a BCVA of 6/6 or better at the final follow-up. RNFL, visual fields, and fundus grades all trended towards improvement, with most improvement noted by day 360. Common complications included transient diplopia (n = 29, 25%) and worsening of visual function requiring further cerebrospinal fluid (CSF) diversion procedures (n = 20, 17%). Complications were most significant in the 'Other' group with 1/3 of eyes requiring further CSF diversion procedures. Conclusion Our data demonstrates effectiveness in the use of ONSF in papilloedema with visual failure due to IIH or CVST and when other CSF diversion procedures or medical therapies have failed.
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Affiliation(s)
- Shaddy El-Masri
- Royal Melbourne Hospital, Hospital City Campus, Grattan Street, Parkville, VIC 3050, Australia
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Matthew Wilson
- Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Jonathan Goh
- Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Paul Sanfilippo
- Neuroscience Department, The Alfred Hospital, Melbourne, VIC, Australia
| | - Anthony Fok
- Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Thomas Hardy
- Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | | | - Anneke Van Der Walt
- Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Neuroscience Department, The Alfred Hospital, Melbourne, VIC, Australia
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