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Published in Brain Cancer

Expert Opinion / Cases · June 17, 2019

Management of Optic Nerve Sheath Meningioma

Written by
Jose McFaline-Figueroa MD, PhD


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  • Jonathan Knisely

    Jun 21, 2019

    I'm curious about something. How does a 1 x 2 mm tumor cause displacement of the optic nerve? I am imagining that this could only happen if the tumor arose in the optic canal, and caused, as a result of compression of the optic nerve along this confined segment of the optic nerve. If this supposition is correct, a neurosurgical 'unroofing' of the optic canal might provide immediate benefit. I do not advocate for surgical management of the tumor, as disruption of the vasa nervorum would lead to an irreversible optic nerve injury. I advocate radiation therapy to a dose of 50.4 Gy with an emphasis on dose homogeneity within the small irradiated volume, and the use of daily image guidance to assure accurate treatment delivery. 

  • Amir Anvari

    Aug 23, 2019

    I want review of mri by radiologist. if patient  has optic nerve sheat meningioma my recommendation  is radiation therapy  with IMRT to a dose 45 to 50.4 . 

  • Jeremy Rees

    Nov 17, 2019

    Clearly needs IMRT to preserve residual vision in RE but like Dr Knisely I cant see such a tiny meningionlma causing such disruption of the optic nerve function.

  • Andre Dreyer

    May 21, 2021

    MRI with anaesthesia may give a better view as the slightest eye movements degrade the MRI views

  • Apr 22, 2024

    Pending Moderator approval.

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