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

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

Research output: Contribution to journalArticle

4 Scopus citations

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 2016

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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