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LETTER TO EDITOR
Year : 2016  |  Volume : 11  |  Issue : 3  |  Page : 303

Fenestrated optic nerve in craniopharyngioma


Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India

Date of Web Publication5-Apr-2016

Correspondence Address:
Dr. Alugolu Rajesh
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1793-5482.145317

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How to cite this article:
Rajesh A, Reddy DJ, Bhattacharjee S. Fenestrated optic nerve in craniopharyngioma. Asian J Neurosurg 2016;11:303

How to cite this URL:
Rajesh A, Reddy DJ, Bhattacharjee S. Fenestrated optic nerve in craniopharyngioma. Asian J Neurosurg [serial online] 2016 [cited 2019 Nov 12];11:303. Available from: http://www.asianjns.org/text.asp?2016/11/3/303/145317

Sir,

Fenestrated optic nerve (nervus opticus fissus) has been described de novo or in association with ruptured aneurysms of the anterior circulation. Five mechanisms have been described- a penetrating embryonic artery with aneurysm,[1],[2] stream of blood splitting optic nerve during SAH subsequently allowing ingrowth of aneurysm,[3] aggressive unruptured aneurysm,[4] osseous trabeculae [5] (developmental) and de novo.[6],[7]

This 10-year-old child was diagnosed to have sellar, suprasellar craniopharyngioma and was operated with right fronto-temporal craniotomy and excision. There was a tumor bulging from the sella lifting the chiasm and the optic nerves. Following intratumoral decompressionthe left optic nerve was found to be split with the medial portion of left optic nerve thinner than the lateral with a distinct arachnoid layer [Figure 1]. The chiasm was thinned out due to chronic compression by the tumor. There were no arterial loops/aneurysms or osseousbridges separating the two roots.
Figure 1: Subfrontal view showing bilateral optic nerves with split in left optic nerve and openedcapsule of craniopharyngioma

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To the best of our knowledge, this is the first reported case in the literature of a craniopharyngioma associated with a split optic nerve.

 
  References Top

1.
Jea A, Baskaya MK, Morcos JJ. Penetration of the optic nerve by an internal carotid artery-ophthalmic artery aneurysm: Case report and literature review. Neurosurgery 2003;53:996-1000.  Back to cited text no. 1
    
2.
Kanamaru K, Ishida F, Taki W. Splitting and penetration of the optic nerve byan aneurysm arising from the anterior wall of internal carotid artery: Case report. J Neurol Neurosurg Psychiatry 2001;71:525-7.  Back to cited text no. 2
    
3.
Date I, Akioka T, Ohmoto T. Penetration of the optic chiasm by a rupturedanterior communicating artery aneurysm. Case report. J Neurosurg 1977;87:324-6.  Back to cited text no. 3
    
4.
Fujita A, Tamaki N, Yasuo K. Complete penetration of the optic chiasm by anunruptured aneurysm of the ophthalmic segment: Case report. Surg Neurol 2002;57:130-4.  Back to cited text no. 4
    
5.
Choudhry R, Anand M, Choudhry S, Tuli A, Meenakshi A, Kalra A. Morphologic and imaging studies of duplicate optic canals in dry adult human skulls. Surg Radiol Anat1999;21:201-5.  Back to cited text no. 5
    
6.
House PA, Couldwell WT. De novo fenestration of the optic nerve. Caseillustration. J Neurosurg 2005;102:390.  Back to cited text no. 6
    
7.
Lang J. On an intracranially divided optic nerve (N. opticus fissus). Acta Neurochir (Wien) 1990;106:170-3.  Back to cited text no. 7
    


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