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| Name | Optic nerve decompression in a case of hypertrophic pachymeningitis due to Wegener's granulomatosis |
| Video Uploader | Video From fornix00 |
| Upload Date | This Video Uploaded At 12-05-2014 05:21:54 |
| Video Discription | A 57-year-old woman was referred to the ophthalmologic department with subacute blindness of the left eye. This was preceded by headaches, nausea, transient diplopia, 3rd cranial nerve palsy and gait imbalance since six months. On admission the right eye had a normal visual acuity and visual fields. Unfortunately, the vision decreased to counting fingers and she developed an altitudinal scotoma. Amongst others, the MRI of the brain showed a pachymeningitis with compression of both intracanalicular optic nerves, resulting in a wide subarachnoid space around the infraorbital part. Further investigation prompted the diagnosis Wegener's granulomatosis and the patient was treated with high dose corticosteroids. This temporary improved her vision, only to decrease again after cessation of medication. With the eminent blindness of her only functional eye, surgical decompression of the right optic nerve over the course of the optic canal was performed via a pretemporal approach with anterior clinoidectomy. The dura was excised and histology confirmed the diagnosis morbus Wegener. The postoperative course was uneventful and the patient's visual acuity on her right eye almost totally recovered, as well as the visual fields. Even after cessation of high-dose corticosteroids this remained the case. Surgery by: dr. R. Dammers and dr. I. Haitsma, department of neurosurgery, Erasmus MC, Rotterdam, the Netherlands. Video editting by: dr. V. Volovici. |
| Category | Education |
| Tags | Wegener's Granulomatosis (Disease Or Medical Condition) | Neurosurgery (Medical Specialty) | optic decompression | Optic Nerve (Cranial Nerve) | anterior clinoidectomy | Medicine (Field Of Study) |
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