以雙側視力視野受犯表現之蝶鞍部結核瘤－兩病例報告

Parasellar Tuberculoma Presented as Bilateral Vision Decrease and Visual Field Defect-2 Case Report

謝文煜(Wen-Yu Hsieh) ； 莊蕙蓴(Huei-Chun Chung) ； 高玲玉(Ling-Yuh Kao)

《中華民國眼科醫學會雜誌》 34卷2期 (1995/06) Pp. 286-292

https://doi.org/10.30048/ACTASOS.199506.0022

摘要

報告兩例結核性腦膜炎引致之蝶鞍部結核瘤；例一為34歲女性，其雙側視力急速下降並呈現左邊同側性半盲，CT顯示巨大之腫瘤侵及鞍部周圍，MRI證實其符合結核瘤之特徵，且此瘤在治療後半年其體積顯著減少。例二為17歲男性，其左眼視力急速下降且雙眼視野呈現Bitemporal hemianopsia，比較眼部病徵出現之前與之後所做的兩次MRI films，顯示視交叉部位有腫大的現象。兩例皆投與類固醇並持續其原有的抗結核藥物，兩例之視力、視野及色覺均獲極大改善。例一經治療後，其因腦下垂體受犯而導致之次發性無月經，也恢復正常。

並列摘要

Tuberculomas account for up to 30% of all intracranial mass in endemic areas. In more developed country, however, CNS tuberculoma is rare. We reported two cases of parasellar tuberculomas which developed during treatment for TB meningitis. Case one is a 34 y/o female, who suffered from bilateral vision decrease and left homonymous hemianopsia 2 months after the initial presentation of TB meningitis. CT and MRI showed large parasellar tuberculomas infiltration. Case two is a 17 y/o male, he suffered from vision decrease in his left eye and bitemporal hemianopsia. MRI also showed chiasmal lesion which was not found on previous MRI performed 2 weeks before when only meningeal sign presented. After systemic corticosteroid added in anti-TB therapy, both patients got dramatic improvement in visual acuity, visual field and color vision. Case one also suffered from amenorrhea before parasellar tuberculoma was diagnosed, she regained her normal menstration after treatment.

並列關鍵字

Parasellar tuberculoma ； Homonymous hemianopsia ； Bitemporal hemianopsia ； Secondary amenorrhea