PMC4110121_01
Head magnetic resonance images with contrast medium showing a well-demarcated skull base tumor compressing the optic chiasm upward and abnormal mesh-like enhancement around the right internal carotid artery terminal and at the distal portion of the anterior cerebral artery (arrowheads). (A) Coronal image. (B) Sagittal image.
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Abnormal mesh-like enhancement was seen in the right half of the tumor around the right ICA terminal and also at the distal portion of the anterior cerebral artery (ACA) in the convexity (Fig. 1).
Head magnetic resonance angiogram revealing severe stenoses of the bilateral internal carotid artery terminals and moyamoya vessels.
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ICA terminals and moyamoya vessels around the horizontal segment of the ACA and the middle cerebral artery (Fig. 2). Iodine-123 N-isopropyl-p-iodoamphetamine single-photon emission computed tomography using the autoradiographic method indicated that cerebral blood flow and cerebrovascular reactivity were apparently compromised bilaterally (Fig. 3).
Iodine-123 N-isopropyl-p-iodoamphetamine single-photon emission computed tomography scans revealing severe reduction of cerebral blood flow, especially in the right hemisphere, and the steal phenomenon bilaterally after injection of acetazolamide.
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ICA terminals and moyamoya vessels around the horizontal segment of the ACA and the middle cerebral artery (Fig. 2). Iodine-123 N-isopropyl-p-iodoamphetamine single-photon emission computed tomography using the autoradiographic method indicated that cerebral blood flow and cerebrovascular reactivity were apparently compromised bilaterally (Fig. 3).
Intraoperative photograph showing moyamoya vessels on the surface of the atrophic pale optic chiasm.
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The tumor was removed after dissection from the lower plane of the optic chiasm (Fig. 4).