TUBERCULUM SELLAE MENINGIOMA CAUSING VISUAL IMPAIRMENT-VISUAL RECOVERY AFTER TUMOUR RESECTION

Abstract

A 41-year-old woman presented with sudden progressive loss of vision in the right eye since 10 days and frontal headache since 5 days. Patient had no history of any trauma, vomiting and seizures. After Patient's ophthalmologic, neurosurgery evaluation was diagnosed to have Tuberculum sellae meningioma which caused vision loss. After surgery, patient's best corrected visual acuity improved from perception of light and projection of rays to 6/9. INTRODUCTION: Meningiomas of anterior skull account for 40% of all intracranial meningiomas. ([1]) 25% of these are tuberculum sellae (TS) tumors with three times more female preponderance and usually diagnosed in the fourth or fifth decade.([2]) Meningiomas of the TS (member of a group called ``parasellar meningiomas'') arise from the limbus sphenoidale, chiasmatic sulcus and tuberculum.([3]) Patients with TS meningiomas present visual symptoms mimicking a pituitary macroadenoma. So, correct diagnosis and management require appreciation of clinical, neuroimaging and surgery related features that distinguish TS meningiomas from other tumors. Patients with TS meningiomas present with either monocular or binocular visual loss which is the most common symptom. These tumors present with gradual visual deterioration secondary to optic chiasma compression and if untreated complete blindness may occur. Many neurosurgeons reported TS meningiomas have a high tendency to extend into the optic canal regardless of their size.([4, 5]) Here, we like to report one such case where early intervention by us saved patient loosing vision permanently.