ID | 57584 |
フルテキストURL | |
著者 |
Tomita, Yusuke
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Fujii, Kentaro
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
0000-0002-6942-9919
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Imoto, Ryoji
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Mitsui, Takashi
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Mishima, Sakurako
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Masuyama, Hisashi
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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Date, Isao
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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抄録 | Background Cavernous malformation of the anterior visual pathway is rare, especially in pregnant woman. Planning a treatment strategy with cross-disciplinary specialists is important.
Case description A 27-year-old pregnant woman presented with acute hemorrhage around the right optic nerve and chiasm, manifesting as poor vision in both eyes. Examination revealed right-eye deteriorated acuity and bilateral temporal hemianopsia. Computed tomography showed an oval high-density mass in the suprasellar region. Gradient echo-based T2-weighted magnetic resonance imaging showed the lesion to be hypointense (possibly a hematoma) and mainly in the optic chiasm. Fluid attenuated inversion recovery imaging showed a bilateral optic tract surrounding the lesion, which enlarged over 1 week, increasing the loss of visual function. Five days after admission, she delivered a healthy >2500-g baby by cesarean section (CS). Right frontotemporal craniotomy was performed 7 days after CS. Incision of the right optic nerve's lateral surface revealed clotted blood with abnormal vascular construction from the right side of the chiasm. We removed the hematoma and vascular lesion. Visual evoked potentials were detected only after optic chiasm decompression. Histological evaluation revealed a hematoma-like lesion with capsules and hemosiderin deposition, suggesting cavernous malformation. Her postoperative recovery was uneventful, with right visual acuity returning to normal, and her visual field not deteriorating any more. Conclusion Devising a treatment strategy with the obstetrician was important in this case to manage the hematoma and cavernous malformation safely. |
キーワード | Optic nerve
Cavernous hemangioma
Pregnant
Visual evoked potential
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発行日 | 2019-12-31
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出版物タイトル |
Interdisciplinary Neurosurgery
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巻 | 18巻
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出版者 | Elsevier
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開始ページ | 100489
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ISSN | 22147519
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2019 The Authors. Published by Elsevier B.V.
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論文のバージョン | publisher
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DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1016/j.inat.2019.100489
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ライセンス | http://creativecommons.org/licenses/by-nc-nd/4.0/
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Citation | Yusuke Tomita, Kentaro Fujii, Kazuhiko Kurozumi, Ryoji Imoto, Takashi Mitsui, Sakurako Mishima, Kenichi Inagaki, Hisashi Masuyama, Isao Date, Cavernous malformation of the optic chiasm with continuous hemorrhage in a pregnant woman: A case report, Interdisciplinary Neurosurgery, Volume 18, 2019, 100489, ISSN 2214-7519, https://doi.org/10.1016/j.inat.2019.100489.
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オープンアクセス(出版社) |
OA
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オープンアーカイブ(出版社) |
非OpenArchive
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