Neurosurgery of the visual pathway

Abstract

The visual pathways take an extraordinary and extensive intraorbital and intracranial course from the globe to the visual cortex within the occipital lobes. Hence, a large number of orbital and intracranial pathologies interfere with the optic pathways. The diagnosis and treatment of these pathologies demands an interdisciplinary team with ophthalmologists, neuroradiologists, neurosurgeons, and radiation therapists. The management algorithm takes into consideration presenting signs and symptoms, as well as ophthalmologic and imaging findings. It requires a multimodal treatment protocol depending on the biological nature and location of the pathology. Modern neurosurgery applies a vast range of operative approaches and microsurgical techniques to remove intra- and extra-axial lesions of the optic pathways. The neurosurgical management is enhanced by recent advances of intraoperative image guidance and electrophysiological monitoring to face the challenge of preserving function.