A Case of Optic Neuritis Concomitant with Pituitary Tumor during Pregnancy

• Published in: World neurosurgery Vol. 93; pp. 488.e1 - 488.e4
• Main Authors: Yamaguchi, Rei, MD, PhD, Kohga, Hideaki, MD, PhD, Tosaka, Masahiko, MD, PhD, Sekine, Akiko, MD, Mizushima, Kazuyuki, MD, PhD, Harigaya, Yasuo, MD, PhD, Yoshimoto, Yuhei, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2016
• Subjects: Adult; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Nerve Compression Syndromes - diagnostic imaging; Nerve Compression Syndromes - etiology; Nerve Compression Syndromes - prevention & control; Neurosurgery; Optic neuritis; Optic Neuritis - diagnostic imaging; Optic Neuritis - etiology; Optic Neuritis - prevention & control; Pituitary Neoplasms - complications; Pituitary Neoplasms - diagnostic imaging; Pituitary Neoplasms - surgery; Pituitary tumor; Pregnancy; Pregnancy Complications, Neoplastic - diagnostic imaging; Pregnancy Complications, Neoplastic - therapy; Treatment Outcome; magnetic resonance; MR; pituitary tumor; MS; multiple sclerosis; pregnancy; aquaporin 4; DWI; diffusion-weighted MR imaging; AQP4; optic neuritis; ON; Pregnancy; Pituitary tumor; MRI; Optic neuritis
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2016.06.103

Abstract Background Optic neuritis (ON) is unilateral painful optic nerve inflammation in a young healthy female diagnosed by excluding glaucoma. ON onset during pregnancy is rare with only two reported cases. Case Description A 35-year-old previously healthy parous woman was pregnant with her second child. She suffered rapidly progressive visual acuity loss. Magnetic resonance (MR) imaging showed pituitary tumor. Emergency surgery was performed for optic nerve compression. However, her visual impairment worsened. Postoperative diffusion-weighted MR imaging showed high intensity in the bilateral optic nerves, and ON was diagnosed. Administration of methylprednisolone was effective and her visual acuity recovered over 6 months. Conclusions Associated pituitary macroadenoma complicated the true diagnosis, as contrast medium could not be used in pregnancy. The diffusion-weighted MR imaging findings were useful to diagnose this complex clinical condition.