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Brain Cancer
Center of Excellence
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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
Mar 29, 2024
Pending Moderator approval.
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Jonathan Knisely
Jun 21, 2019
Amir Anvari
Aug 23, 2019
Jeremy Rees
Nov 17, 2019
Andre Dreyer
May 21, 2021
Mar 29, 2024
Pending Moderator approval.