Septo-optic dysplasia, first described by de Morsier in 1956, is an uncommon congenital midline structural abnormality of the brain, including agenesis of septum pellucidum, primitive optic ventricle and dysplasia of the optic chiasm, optic nerves, and infundibulum. Agenesis of septum pellucidum, initially thought to be an integral part of this syndrome, is inconstant and not an essential part of the disorder. Also, it reveals a variable spectrum of associated abnormalities in disturbed hypothalamic-pituitary function. We recently experienced 3 patients of septo-optic dysplasia who showed bilateral optic disc hypoplasia clinically and midline structural abnormalities in computerized tomography(CT) or magnetic resonance imaging(MRI).
Brain ; Humans ; Optic Chiasm ; Optic Nerve ; Septo-Optic Dysplasia* ; Septum Pellucidum

PURPOSE: This is study of whether 3-D conformal radiotherapy for carcinomas of the ethmoid sinus were better than those treated with conventional 2-D plan. MATERIALS AND METHODS: The 3-D conformal treatment plans were compared with conventional 2-D plans in 4 patients with malignancy of the ethmoid sinus. Isodose distribution, dose statistics, and dose volume histogram of the planning target volume were used to evaluate differences between 2-D and 3-D plans. In addition, the risk of radiation exposure of surrounding normal critical organs are evaluated by means of point dose calculation and dose volume histogram. RESULTS : 3-D conformal treatment plans for each patient that the better tumor coverages by the planning target volume with improved dose homogeneity, compared to 2-D conventional treatment plans in the same patient. On the other hand, the radiation dose distributions to the surrounding normal tissue organs, such as the orbit and optic nerves are not significantly reduced with our technique, but a substantial sparing in the brain stem and optic chiasm for each patient. CONCLUSION : Our findings represented the potential advantage of 3-D treatment planning for dose homogeniety as well as sparing of the normal tissue surrounding the tumor. However, further investigational studies are required to define the clinical benefit.
Brain Stem ; Ethmoid Sinus* ; Hand ; Humans ; Optic Chiasm ; Optic Nerve ; Orbit ; Radiotherapy, Conformal*

Cavernous malformations (CMs) arising from the optic nerve and chiasm are extremely rare. The authors present a case of 39-year-old woman with CMs of the optic chiasm. She was referred due to sudden onset of bitemporal hemianopsia and headache, the so-called 'chiasmal apoplexy'. MRI findings suggested a diagnosis of hemorrhage and vascular malformation of the optic chiasm. Pterional craniotomy revealed an intrachiasmatic cavernous malformation with hemorrhage. The malformation was totally excised, but field deficits remained unchanged after surgery.
Adult ; Caves ; Craniotomy ; Female ; Headache ; Hemianopsia ; Hemorrhage ; Humans ; Optic Chiasm ; Optic Nerve ; Stroke ; Vascular Malformations

A twenty nine-year-old woman has suffered for ten years from progressive proptosis and loss of vision in the right eye. Her right eye had deviated out-and-upwards, and its visual acuity was tested by hand motions. With the help of a brain and orbit CT, the tumor was found around the optic nerve and in the parasellar area. This tumor was surgically removed twice by Kroenlein operation and craniotomy, and was treated with irradiation(total dose: 5400 RAD). It was histopathologically diagnosed as astracytoma grade I. In the consecutive study, no evidence of recurrence of the tumor in either the orbit or brain was found.
Brain ; Craniotomy ; Exophthalmos ; Female ; Hand ; Humans ; Optic Chiasm* ; Optic Nerve Glioma* ; Optic Nerve* ; Orbit ; Recurrence ; Visual Acuity

The association of abnormalities of the optic nerves, optic chiasm, and optic tracts with anomalies of the midline structures in the brain-an absent septum pellucidum etc was reported and called "septo-optic dysplasia". Also, it was noted that septo-optic dysplasia could be associated with hypopituitary dwarfism. It occurs more commonly in first born children and children born to young or diabetic mothers. We report a case of septo-optic dysplasia with literature, who had complained of severe visual impairment associated with nystagmus, bilateral optic nerve hypoplasia, absent septum pellucidum, and normal range of hormone studies.
Child ; Dwarfism ; Humans ; Mothers ; Optic Chiasm ; Optic Nerve ; Reference Values ; Septo-Optic Dysplasia* ; Septum Pellucidum ; Vision Disorders ; Visual Pathways

PURPOSE: Purpose :To evaluate the position and transverse dimension of the adult optic chiasm in normal Korean adult. MATERIALS AND METHODS: The authors analysed 3D coronal volume images (TR/TE= 30/13, flip angle= 30 degrees) of 136 normal adult subjects without known visual abnormality. All MRI examinations were performed using a 0.5T system. MRI was reviewed retrospectively to determine the position (horizontal and tilted) of the potic chiosm and the transverse dimension of the optic chiasm was measured. RESULTS: Seventy-five (55%) of 136 normal subjects had horizontal position, and sixty-one (45%) had tilted position. Thirty-eight (62%) of 61 with tilted position showed higher position on the right side, and twenty-three (38%) showed higher position on the side. The average transverse dimension(mean SD) was 15.2 +/- 0.7mm in men and 14.6 +/- 1.0mm in women. The difference of transverse dimension between men and women was statistically significant. CONCLUSION: Tilted position of the adult optic chiasm on coronal MRI was seen in approximately half of normal adults. The average of transverse dimension of normal optic chiasm was 15mm.
Adult* ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Optic Chiasm* ; Retrospective Studies

The juvenile pilocytic astrocytoma has histologically the same features as the adult type one. Contrary to the adult type, the parallel arrangement of fibrils in long thin tapering cells of the tumor is peculiarly independent of the environment in which the tumor is growing and it gives rise to the main tumor mass that is usually well circumscribed. The overall incidence is relatively rare of all the brain tumor, it occurs in children mainly from three to five of age. Its predilection sites are the hypothalamus and the optic chiasm. We are reporting an experience of a juvenile pilocytic astrocytoma in a three years old female patient, involving the hypothalamus, basal ganglia and deep white matter of the temporoparietal lobe of the left side.
Adult ; Astrocytoma* ; Basal Ganglia ; Brain Neoplasms ; Child ; Female ; Humans ; Hypothalamus ; Incidence ; Optic Chiasm

Ischemia is a rare cause of the optic chiasmal syndrome and is sometimes hard to define. The present report describes a 73 year ~ old male with abruptly developed visual field defect involving bitemporal hemianopsia and inferior binasal quadrantanopsia. The MRI study revealed focal anterior hypothalarnic atrophy which might be due to focal infarction. These findings are suggesting common blood supply of superior chiasmal circulation and anterior inferior hypothalamus.
Atrophy ; Hemianopsia ; Humans ; Hypothalamus ; Infarction* ; Ischemia ; Magnetic Resonance Imaging ; Male ; Optic Chiasm* ; Visual Fields

The microsurgical anatomical characteristics of the anterior cerebral artery(ACA) are described. Inequality of horizontal segment of ACA has been reported. The majority of anterior communicating artery (ACoA) aneurysms occur in association with dominance of one A1 and hypoplasia of the other. ACoA has variation such as dimple, fenestration duplication, string, median artery of the corpus callosum and azygos anterior cerebral artery. ACoA gives rise to the perforating branches which feed subcallosal, hypothalamic area and optic chiasm. The recurrent artery of Heubner arises at A1-A2 junction, proximal A2 or distal A1. The distal ACA gives origin to many cortical branches, but there is the large variety of their origin. The aneurysm arising from A1 could be clipped through the pterional route, and those of distal ACA throuph the interhemispheric approach. ACo aneurysm could be approached through pterional or interhemspheric route. Essential points in ACo aneurysm surgery through any approach are to confirm H complex and to clip aneurysmal neck precisely without compromising feeding arteries or perforating branches.
Aneurysm ; Anterior Cerebral Artery* ; Arteries ; Corpus Callosum ; Neck ; Optic Chiasm ; Socioeconomic Factors

The microsurgical anatomical characteristics of the anterior cerebral artery(ACA) are described. Inequality of horizontal segment of ACA has been reported. The majority of anterior communicating artery (ACoA) aneurysms occur in association with dominance of one A1 and hypoplasia of the other. ACoA has variation such as dimple, fenestration duplication, string, median artery of the corpus callosum and azygos anterior cerebral artery. ACoA gives rise to the perforating branches which feed subcallosal, hypothalamic area and optic chiasm. The recurrent artery of Heubner arises at A1-A2 junction, proximal A2 or distal A1. The distal ACA gives origin to many cortical branches, but there is the large variety of their origin. The aneurysm arising from A1 could be clipped through the pterional route, and those of distal ACA throuph the interhemispheric approach. ACo aneurysm could be approached through pterional or interhemspheric route. Essential points in ACo aneurysm surgery through any approach are to confirm H complex and to clip aneurysmal neck precisely without compromising feeding arteries or perforating branches.
Aneurysm ; Anterior Cerebral Artery* ; Arteries ; Corpus Callosum ; Neck ; Optic Chiasm ; Socioeconomic Factors