Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection

Case report

Seunggu (Jude) Han, Stephen T. Magill, Phiroz E. Tarapore, Jonathan C. Horton, Michael W. McDermott

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Tuberculum sellae meningiomas frequently produce visual loss by direct compression from tumor, constriction of the optic nerve (ON) under the falciform ligament, and/or ON ischemia. The authors hypothesized that changes in visual function after tumor removal may be related to changes in blood supply to the ON that might be seen in the pial circulation at surgery. Indocyanine green (ICG) angiography was used to attempt to document these changes at surgery. The first patient in whom the technique was used had a left-sided, 1.4-cm, tuberculum meningioma. Time-lapse comparison of images was done postsurgery, and the comparison of video images revealed both faster initial filling and earlier complete filling of the ON pial circulation, suggesting improved pial blood flow after surgical decompression. In follow-up the patient had significant improvements in both visual acuity and visual fields function. Intraoperative ICG angiography of the ON can demonstrate measurable changes in pial vascular flow that may be predictive of postoperative visual outcome. The predictive value of this technique during neurosurgical procedures around the optic apparatus warrants further investigation in a larger cohort.

Original languageEnglish (US)
Pages (from-to)565-569
Number of pages5
JournalJournal of neurosurgery
Volume125
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Meningioma
Optic Nerve
Blood Vessels
Indocyanine Green
Angiography
Ischemic Optic Neuropathy
Neurosurgical Procedures
Surgical Decompression
Visual Fields
Ligaments
Constriction
Visual Acuity
Neoplasms

Keywords

  • Indocyanine green
  • Meningioma
  • Oncology
  • Optic nerve
  • Pial circulation
  • Pial supply
  • Tuberculum sellae

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection : Case report. / Han, Seunggu (Jude); Magill, Stephen T.; Tarapore, Phiroz E.; Horton, Jonathan C.; McDermott, Michael W.

In: Journal of neurosurgery, Vol. 125, No. 3, 01.09.2016, p. 565-569.

Research output: Contribution to journalArticle

Han, Seunggu (Jude) ; Magill, Stephen T. ; Tarapore, Phiroz E. ; Horton, Jonathan C. ; McDermott, Michael W. / Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection : Case report. In: Journal of neurosurgery. 2016 ; Vol. 125, No. 3. pp. 565-569.
@article{debccd45a439471e842bb25d7c6c319e,
title = "Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection: Case report",
abstract = "Tuberculum sellae meningiomas frequently produce visual loss by direct compression from tumor, constriction of the optic nerve (ON) under the falciform ligament, and/or ON ischemia. The authors hypothesized that changes in visual function after tumor removal may be related to changes in blood supply to the ON that might be seen in the pial circulation at surgery. Indocyanine green (ICG) angiography was used to attempt to document these changes at surgery. The first patient in whom the technique was used had a left-sided, 1.4-cm, tuberculum meningioma. Time-lapse comparison of images was done postsurgery, and the comparison of video images revealed both faster initial filling and earlier complete filling of the ON pial circulation, suggesting improved pial blood flow after surgical decompression. In follow-up the patient had significant improvements in both visual acuity and visual fields function. Intraoperative ICG angiography of the ON can demonstrate measurable changes in pial vascular flow that may be predictive of postoperative visual outcome. The predictive value of this technique during neurosurgical procedures around the optic apparatus warrants further investigation in a larger cohort.",
keywords = "Indocyanine green, Meningioma, Oncology, Optic nerve, Pial circulation, Pial supply, Tuberculum sellae",
author = "Han, {Seunggu (Jude)} and Magill, {Stephen T.} and Tarapore, {Phiroz E.} and Horton, {Jonathan C.} and McDermott, {Michael W.}",
year = "2016",
month = "9",
day = "1",
doi = "10.3171/2015.6.JNS15765",
language = "English (US)",
volume = "125",
pages = "565--569",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "3",

}

TY - JOUR

T1 - Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection

T2 - Case report

AU - Han, Seunggu (Jude)

AU - Magill, Stephen T.

AU - Tarapore, Phiroz E.

AU - Horton, Jonathan C.

AU - McDermott, Michael W.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Tuberculum sellae meningiomas frequently produce visual loss by direct compression from tumor, constriction of the optic nerve (ON) under the falciform ligament, and/or ON ischemia. The authors hypothesized that changes in visual function after tumor removal may be related to changes in blood supply to the ON that might be seen in the pial circulation at surgery. Indocyanine green (ICG) angiography was used to attempt to document these changes at surgery. The first patient in whom the technique was used had a left-sided, 1.4-cm, tuberculum meningioma. Time-lapse comparison of images was done postsurgery, and the comparison of video images revealed both faster initial filling and earlier complete filling of the ON pial circulation, suggesting improved pial blood flow after surgical decompression. In follow-up the patient had significant improvements in both visual acuity and visual fields function. Intraoperative ICG angiography of the ON can demonstrate measurable changes in pial vascular flow that may be predictive of postoperative visual outcome. The predictive value of this technique during neurosurgical procedures around the optic apparatus warrants further investigation in a larger cohort.

AB - Tuberculum sellae meningiomas frequently produce visual loss by direct compression from tumor, constriction of the optic nerve (ON) under the falciform ligament, and/or ON ischemia. The authors hypothesized that changes in visual function after tumor removal may be related to changes in blood supply to the ON that might be seen in the pial circulation at surgery. Indocyanine green (ICG) angiography was used to attempt to document these changes at surgery. The first patient in whom the technique was used had a left-sided, 1.4-cm, tuberculum meningioma. Time-lapse comparison of images was done postsurgery, and the comparison of video images revealed both faster initial filling and earlier complete filling of the ON pial circulation, suggesting improved pial blood flow after surgical decompression. In follow-up the patient had significant improvements in both visual acuity and visual fields function. Intraoperative ICG angiography of the ON can demonstrate measurable changes in pial vascular flow that may be predictive of postoperative visual outcome. The predictive value of this technique during neurosurgical procedures around the optic apparatus warrants further investigation in a larger cohort.

KW - Indocyanine green

KW - Meningioma

KW - Oncology

KW - Optic nerve

KW - Pial circulation

KW - Pial supply

KW - Tuberculum sellae

UR - http://www.scopus.com/inward/record.url?scp=84987667492&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987667492&partnerID=8YFLogxK

U2 - 10.3171/2015.6.JNS15765

DO - 10.3171/2015.6.JNS15765

M3 - Article

VL - 125

SP - 565

EP - 569

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 3

ER -