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Q: double vision
asked by: nabb on June 16th, 2009
New User
Dear Doctor,

my 6 years daughter suffer only from double vision.
eyes exam is perfect. my daughter is very healthy,
very clever in school.
the doctor ask for am IRM.
the result is:

Resultats: fosse posterieure:presence d’un processus expansif heterogene et infiltrant de 4.1CM d’axe transverse de 3.7CM de hauteur et de 3.1CM d’axe antero-posterieur accupant le tronc cerebral avec un aspect exophytique de la calotte protuberantielle nottament en para-sagital gauche encastrant le tronc basilaire qui reste permeable.Cette lesion ne semble pas s’etendre vers les pedoncules cerebelleux moyens ni superieurs.Absence d’extension mesencephalique identifialble.La masse deforme et aplatie le plancher du quatrieme ventricule sans dilatation de l’aqueduc de silvius.Une prise de contraste ovalaire irreguliere de 1.3x1CM est visible dans la partie anterieure et lateral gauche de ce processus. La prise de contraste parait en cocarde irreguliere et pourrait comporter des residus hemorragiques en hyposignal sur les sequences T2 s’accentuant sur les sequences en diffusion protonique.Une invagination de la masse exophytique est visible en avant de l’olive bulbaire au dessus et en avant de l’abouchement du segment V4 de la vertebrale gauche au tronc basilaire sans engagement des amygdales cerebelleuses dans les trous accipitales.Absence de rehaussement duro-meninge pathologique identifiable par ailleurs. Etage sus-tentoriel : expansion normale et symetrique des ventricules lateraux sans deplacement des structures medians. Absence d ’anomalie majeure du signal de la substance blanche peri-ventriculaire sous-corticale. Integrite des noyaux gris centraux, du calleva et du revetement cortical. Le sinus sagital superieur et permeable.Conclusion:L’IRM cerebrale realisee avant et après injection du produit de contraste releve la presence d’un large processus expansif et infiltrant du tronc cerebral deformant le quatrieme ventricule sans dilatation des cavites ventriculaire a l’etage sus-tentoriel.La masse comporte une zone de rehaussement heterogene en cocarde irreguliere.L’hypothese d’une lesion neuro-gliale et a soulever en premier.

we go to the hostipal,and the oncologyst said that the only treatment is
radiotherapy. the doctor don't beleive me when we said that
my daugther is very healthy and she go for swimming
and for a class of dance, and only have double vision.


it is a tumor? what kind of tumor?
can radiotherapy cure the tumor?
should we ask another opinion.

thanks in advance.
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MandMs
replied on June 17th, 2009
Extremely eHealthy
Double vision as a symptom of brain tumor is suggestive for tumors located in the brain steam or middle part of the brain.
These tumors are known as brain steam gliomas.
Although, the double vision can be the most common presenting symptom of these type of tumors, still patients can have other complains like weakness of one side of the body and face, inability to close the eyelids properly, difficulties with walking, speaking, swallowing.
Brain steam gliomas occur almost exclusively in children, and symptoms are often present for 6 months or less at time of diagnosis.
Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls.
Radiotherapy is the main treatment with use of some chemotherapeutic agents in certain cases.
Typical brain steam gliomas are very progressive and refractive (nonresponding to the applied treatment), often with poor prognosis.
Atypical brain steam gliomas can carry an exceptional prognosis, with long-term survivals frequently reported.
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