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CONTRALATERAL OPTIC NEUROPATHY IN SPHENOID WING MENINGIOMA WITH MIDBRAIN COMPRESSION

Inderpreet K., Ayeesha M. Z., Rupini Y., Norshamsiah M. D. & Jemaima C. H.
abstract
A 38-year-old lady presented with progressively worsened binocular diplopia for 2 months associated with periorbital pain, headache, nausea and right sided tinnitus. Ophthalmic examination revealed Left Relative Afferent Pupillary Defect (RAPD) with impaired optic nerve function and right 6th cranial nerve palsy. Fundus examination showed bilateral optic disc swelling, more in the left eye. Humphrey Visual field showed left superior quadrant field defect. MRI Scan revealed right sphenoid meningioma with midline shift causing compression of the adjacent ventricle. She underwent preoperative angioembolization of the tumour followed by right craniotomy and tumour excision. Post-operatively, the diplopia, RAPD, optic disc swelling and visual field defect resolved. Optic neuropathy may be worst on the contralateral side of a space-occupying lesion despite bilateral optic disc swelling.
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