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September 1955

The Optic Nerve Sheath PathwayIts Role in Spread of Foreign Bodies and Tumor Cells from Cranial Cavity to Orbit

Author Affiliations

New York
From the Laboratory Division and Department of Ophthalmology, Montefiore Hospital.; Resident in Pathology and Trainee of the National Institute of Neurological Diseases and Blindness, U. S. Public Health Service (Dr. Levine). Resident in Ophthalmology (Dr. Bronstein).

AMA Arch Ophthalmol. 1955;54(3):369-372. doi:10.1001/archopht.1955.00930020375006

Anatomical and injection studies upon cadavers have demonstrated the continuity of the cranial subdural and subarachnoid spaces with the corresponding spaces around the optic nerve.* Experiments with living animals have shown that colloidal material and nondiffusible dyes injected in the cranial subarachnoid space reach the optic nerve sheath.† It is generally accepted that intracranial cerebrospinal fluid pressure is transmitted to the eye through the subarachnoid space around the optic nerve.7 Transmission of particulate matter through the optic nerve sheath in vivo is suggested by filling of the sheath with inflammatory cells in cases of meningitis.7 However, there is controversy as to whether blood from an intracranial subarachnoid hemorrhage fills the optic nerve sheath by direct extension3 or whether the optic nerve sheath hemorrhages in this condition are a secondary phenomenon due to increased venous pressure‡

The following three cases are presented because they provide some additional evidence

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