Vision treatment strategy for acute blindness in adolescent female with diffuse leptomeningeal glioneuronal tumor

Abstract

Diffuse leptomeningeal glioneuronal tumor with the first symptom of acute rapid blindness in both eyes are rare in adolescents. We present a case of an adolescent female without a history of cancer who developed a dramatic loss of vision and eventually blindness, and was diagnosed as diffuse leptomeningeal glioneuronal tumor by cerebrospinal fluid cytology and enhanced MRI. In order to save vision, under the condition of ineffective dehydration treatment, timely emergency surgery to implant Ommaya sac drainage cerebrospinal fluid. According to the pathophysiological mechanism of cerebral edema, we added Edaravone to scavenge oxygen free radicals, Alprostadil to improve microcirculation, Monosialotetrahexosylganglioside nutrient nerve, Butylphthalide to promote collateral circulation, combined with hyperbaric oxygen and acupoint injection of Anisodine. Finally, the patient’s vision returned to normal. Conclusion: when dehydration treatment is ineffective, timely surgery to reduce intracranial pressure, combined with comprehensive treatment, can effectively save vision.

Keywords:

• Diffuse leptomeningeal glioneuronal tumor
• visual impairment
• Ommaya sac
• cerebrospinal fluid cytology
• butylphthalide

Acknowledgments

We are grateful to the medical staff who have treated this patient carefully. This article is a clinical observation study, no funding.

Disclosure statement

No potential conflict of interest was reported by the author(s).