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Non-Compressive Disorders of the Chiasm

Purvin, Valerie ; Kawasaki, Aki

In: Current Neurology and Neuroscience Reports, 2014, vol. 14, no. 7, p. 1-8

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    Title
    • Non-Compressive Disorders of the Chiasm
    Author
    • Purvin, Valerie. Department of Ophthalmology, Indiana University Medical Center, Indianapolis, IN, USA
    • Kawasaki, Aki. Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Current Neurology and Neuroscience Reports, 2014, vol. 14, no. 7, p. 1-8. Springer US; http://www.springer-ny.com
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:326411
    Summary
    Chiasmal dysfunction produces a characteristic clinical picture, regardless of the mechanism. In most cases a compressive lesion is the cause. In occasional cases, however, no such extrinsic mass is found and other possible etiologies must be explored. In some of these cases, the pathologic process is identifiable with appropriate neuroimaging. For example, inflammation, infiltrative tumors, and radiation necrosis produce intrinsic chiasmal enhancement. Chiasmal ischemia may require specialized magnetic resonance (MR) sequences for diagnosis. Chiasmal hemorrhage, trauma and chiasmal herniation typically produce distinctive changes on noncontrasted imaging. In cases of metabolic insult, either toxic or hereditary, radiographic changes are typically absent. In each of these, the correct diagnosis can usually be made with a combination of clinical and radiographic features.