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KMID : 0359819730020010089
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Journal of Korean Neurosurgical Society
1973 Volume.2 No. 1 p.89 ~ p.96
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Tumors of Optic Pathways
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韓允善/Hane, Y.S.
韓勇彪/朴兌城/李憲梓/Han, Y.P./Park, T.S./Lee, H.J.
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Abstract
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Gliomas of the. optic pathways make up a relatively small portion of all neoplasm of the brain with an incidence of 0.84-3.6%. Since this tumor arises in the tract of optic pathways, one might expect to find any of the types of neoplasm arising in the glial tissue. Consquetly the absence of mitoses is an evidence that these tumors do not enlarge by cell invasion. A collateral hyperplasia of adjacent glia and connective tissue is an ample evidence of the benignancy, although the most gliomata of the optic. nerve are indolent. Two cases of -this communication comprised a tumor-growth into the 3rd ventricle obstructing both foramina of Monro with subsequent clinical features of hydrocephalus.
There is difficulty in obtaining X-ray films showing the optic canal in, its entirety. The presence of full sized optic foramina in young children is also significant. The combination of J-shaped sella deformity with -enlargement of the optic canal was associated with the massive intracranial extension of the tumors with obstructive hydrocephalus. Conary ventriculography was a valuable diagnostic adjunct outlining the extent of the tumor growth.
Exploratory crainotomy should not be negated by the reason that mordern neurosurgical procedures can permit an accurate diagnosis and assesment of the extent of the tumors. Incomplete excision is no sin as Hudson (1912) established so convincingly. We continue to believe that histological confirmation- of ,the. presence of the tumor represents a proper and justifiable practice. Our experience suggests that efforts to relieve the increaeed intracranial pressure by shunt procedure rather than radical excision of the tumor mass are indicated.
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