SUPRASELLAR meningiomas are associated in typical instances with atrophy of one or both optic nerves and bitemporal hemianopsia, with or without changes in the sella turcica and with or without symptoms of endocrine disturbance. In some circumstances, optic nerve atrophy may be minimal or altogether absent, the only evidence of chiasmal compression being a bitemporal hemianopsia for form or color or both. In almost all instances, the symptoms are slowly progressive, with visual loss prominent and headache equally disabling.
Not sufficiently well recognized as part of the suprasellar tumor syndrome is the occurrence of sudden visual loss with scotomas in the visual fields, associated with more or less prominent headache. The development of symptoms may be so rapid and may simulate so closely in the early stages the clinical picture of retrobulbar neuritis that great care must be exercised to avoid discarding a diagnosis of suprasellar meningioma. For this reason,