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April 1937


Arch NeurPsych. 1937;37(4):929-958. doi:10.1001/archneurpsyc.1937.02260160229021

Syphilis is ever a transgressor, spreading from one focus to neighboring structures. The optic chiasm is not exempt, and since it is near other important parts of the brain, the syndrome produced is, as in other situations of syphilis, an accident of location. The 5 cases of syphilitic chiasmal arachnoiditis to be described were observed in the neurologic service of Dr. Foster Kennedy at the Bellevue Hospital. Four patients presented the characteristic chiasmal syndrome of primary atrophy of the optic nerve and heteronymous visual field defects, usually bitemporal.1 The fifth case was atypical in that there was a different ophthalmoscopic picture, consisting of marked bilateral papiledema without any increase in intracranial pressure or dilatation of the ventricular system. It is included in this report because the condition is significant as a clinical entity.

Syphilitic arachnoiditis of the optic chiasm is of interest for two reasons: (1) It emphasizes the