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Article
November 1940

PRECHIASMAL SYNDROME PRODUCED BY CHRONIC LOCAL ARACHNOIDITIS: REPORT OF THREE CASES

Author Affiliations

PHILADELPHIA
From the Department of Ophthalmology, Temple University School of Medicine.

Arch Ophthalmol. 1940;24(5):940-947. doi:10.1001/archopht.1940.00870050090006
Abstract

Prechiasmal and chiasmal inflammatory lesions which produce a slowly progressive syndrome suggestive of tumor can be broadly placed in two groups, namely: (1) basal gummatous meningitis and (2) chronic local arachnoiditis. The former can be diagnosed readily by the serologic and cytologic changes in the cerebrospinal fluid and needs no further consideration here. The latter group usually presents a clinical syndrome so like tumor similarly situated that it is almost impossible to predicate the underlying lesion. Surgical exploration reveals the optic nerve or the chiasm to be covered with definite inflammatory exudates and bound down by a single adhesion or a mass of adhesions. Tumefaction of the inflammatory exudate, which consists of encysted fluid, may also be present. The type of pathologic process found will depend on whether the clinical ophthalmologic findings suggest a space-taking lesion, similar to a basofrontal tumor, or a chiasmal lesion, such as an infrasellar or

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