Prolapsing Gyrus Rectus as a Cause of Progressive Optic Neuropathy

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The pahogenesis of optic neuropathy caused by neurovascular compression or by similar mechanisms is unclear. Thin-slice magnetic resonance(MR)imaging was parformed in 69 patients with optic neu-ropathy without demonstrable ophthalmological lesions(57.0 ±17.1 years of age)and 102 normal sub-jects(57.7 ±13.9 years of age). The MR imaging features were classified into "no compression" by the internal carotid artery(ICA), "compression" by the ICA, "no contact" with the anterior cerebral artery(ACA) or the gyrus rectus, "contact" with either or both, "compression" by the ACA, and "compression" by the gyrus rectus. The Spearman correlation coefficients were calculated between patients or controls, the MR classification, and the age, and the number of paients in each MR clas-sification were evaluated by the x^2 test. Five of the 69 patients with rapidly progressive sympotoms were operated on via the frontotemporal approach. The MR imaging feature of "compression" by the gyrus rectus was the best predictor of optic neuropathy (Spearman correlation coefficients p=-0.23646, p<0.0018). This MR imaging feature was observed in 38 of 69 patients and in 32 of 102 controls (p=0.002). Compression of the nerve by the gyrus rectus or the ACA was confirmed in all five operated cases. Decompression of the nerve was fully achieved in four of the five patients, and their symptoms have not progressed since then. Optic neuropathies due to compression by the pro-lapsing gyrus rectus are not well understood. Such neuropathies may be detected by MR imaging.
日本脳神経外科学会の論文
2000-06-15

Prolapsing Gyrus Rectus as a Cause of Progressive Optic Neuropathy

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