In September 1926 a white man 25 years of age presented himself with a history of failing vision of six months' duration. He had suffered an occasional severe frontal headache ever since he had received an injury to the back of his head from a fall seven years prior to admission to the hospital. Roentgenograms of the skull showed no lesion ; an examination of the sinuses revealed no pathologic process. The Wassermann reactions of the blood and spinal fluid were negative. Both optic nerve heads showed a mixed type of atrophy (visible lamina ; sharply defined margin, and markedly reduced vessels, especially arteries). The fields of vision suggested a suprasellar lesion ; the history of injury, a chronic serous meningitis or arachnoiditis involving the chiasm. The patient gave his consent for an exploratory craniotomy, which was performed on March 7, 1927, by Dr. George J. Heuer. The pia-arachnoid over the whole area
VAIL D. OPTOCHIASMIC ARACHNOIDITIS: IMPORTANCE OF A MIXED TYPE OF ATROPHY OF THE OPTIC NERVE AS A DIAGNOSTIC SIGN. Arch Ophthalmol. 1938;20(3):384–394. doi:10.1001/archopht.1938.00850210040005
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