A 46-year-old woman came to the Ophthalmology Department complaining of decreased vision in her right eye for a year.
He did not report headache, transient darkening or episodes of double vision.
She had not been treated with Lithium, tetras, vitamin A or corticosteroids.
He had not changed weight in the last year.
The neurological examination was normal.
Visual acuity corrected was 20/25 in the right eye and 20/20 in the left eye.
Anterior pole helix lamp examination, intraocular motility, intrinsic ocular pressure and ocular motility were normal.
On examination of the eye fundus, mild borrosity and elevation of both papillae were observed, without hyper- or hemorrhages, with greater edema in the right bundle of fibers or bundle branch.
Ultrasound did not show evidence of optic nerve damage.
Visual field examination with Humphrey perimeter (Carl Zeiss Meditec, Inc., Dublin, California) SITA 24-2 showed increased blind spot with inferior nasal defect in both eyes.
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Magnetic resonance imaging (MRI) of the brain showed moderate dilatation of the supratentorial ventricular system, with no evidence of space occupying lesions.
With these findings, and without contraindications, a lumbar puncture was performed in order to measure cerebrospinal fluid pressure (CSF) and to be able to filiate the hydrocephalia, which revealed a high opening pressure of 15 cmH294 mg.
A spinal cord NMR was then performed, which detected the presence of a large intradural, polylobulated mass, eccentric to the spinal cord on which the mass effect was exerted, which was enhanced after the administration of a vertebral lesion.
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Three months after surgery the patient had recovered from her visual problems, with normalization of the perimetry and the optic nerve head, with some residual gliosis.
After six months, ventricular dilation had been resolved.
