dr mohammad shehadeh salam hirbawi n.
Skip this Video
Loading SlideShow in 5 Seconds..
Tumours PowerPoint Presentation
Download Presentation

Loading in 2 Seconds...

play fullscreen
1 / 15

Tumours - PowerPoint PPT Presentation

  • Uploaded on

Dr. Mohammad Shehadeh Salam Hirbawi. Tumours. Optic nerve glioma. Slow-growing. Pilocytic astrocytoma which typically affects children. girls more often than boys. Approximately 30% of patients have associated nurofibromatposis-1 and in these patients the prognosis is better.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Tumours' - selene

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
optic nerve glioma
Optic nerve glioma
  • Slow-growing.
  • Pilocytic astrocytomawhich typically affects children.
  • girls more often than boys.
  • Approximately 30% of patients have associated nurofibromatposis-1 and in these patients the prognosis is better.


  • Most frequently in the first decade of life(median age 6.5 years).
  • Slowly-progressive visual loss, followed later by proptosis.
  • Although this sequence may occasionally be reversed.
  • Acute loss of vision as a result of haemorrhage into the tumour is uncommon.


  • Proptosis often with inferior dystopia.
  • The optic nerve head is initially swollen and subsequently becomes atrophic.
  • Opticociliary collaterals and central retinal vein occlusion are ossasionally seen.
  • Intracranial spread to the chiasm and hypothalamus may develop.


  • shows a fusiform enlargement of the optic nerve with a clear cut margin produced by the intact dural sheath.


  • Shows gliomas.
  • may also show intracranial extension.


  • May not be required in patient with no evidence of growth,Good vesion and no cosmetic deformity.
  • surgical excision with preservation of the globe is required for large or growing tumours that are confined to the orbit particularlly if vision poor and proptosis significant.
  • Radiotherapy may be combined with chemotherapy for tumours with intracranial extension.


  • Variable.
  • Some tumours have an indolent course with little growth.
  • Others may extent intracranialy and threaten life.


  • malignant gliomas are rare & almost always occur in adults. the prognosis is very poor with almost certain death within one year of diagnosis.
optic nerve sheath meningioma
Optic nerve sheath meningioma
  • Arise from meningothelial cells of the arachnoid villy surroundings the intraorbital or less commonly the intracanalicular portion of the optic nerve.
  • In some cases the tumour merely encircles the optic nerve whilst in others it invades the nerve by growing along the fibrovascularpialseptae.
  • Primary optic nerve sheath meningiomas typically affect middle-aged women.

(c) axial CT of small tumor shows slight thickening & calcification

(d)axial T2-weighted MR in a more advanced case shows fusiform enlargement of the optic nerve & proptosis



  • With gradual unilateral visual impairment .
  • Transient obscurations of vision may be the presenting symptom.


  • The classical triad is:

Visual loss,optic atrophy,opticociliary shunt vessels.


However, the simultaneous occurrence of all three signs in one individual is uncommon.

  • The sequence of involvement is as follows:
  • Optic nerve dysfunction & chronic disc swelling followed by atrophy.
  • Opticocilliary collaterals found in about 30% of cases, regress as optic atrophy supervenes.
  • Restrictive motility defects, particularly in up-gaze, because the tumour may splint the optic nerve.
  • Proptosis caused by intraconal spread-usually develops after the onset of visual loss.


  • this sequence is the opposite of that seen with tumours outside the dural sheath, in which proptosis develops long before optic nerve compression.


  • Shows thickening & calcification of the optic nerve.

MR :

  • More clearly detects smaller tumours & those around the optic canal.


  • May not be required in middle-aged patients with slow-growing tumours because the prognosis is good.
  • Surgical excision is required in young patients with aggressive tumours, particularly if the eye is also blind.
  • Fractionated stereotactic radiotherapy may be appropriate in selscted cases or as adjunctive treatment following surgery.


  • Is good in adults, although the tumour may be more aggressive & sometimes fatal in children.