A 21-year-old woman presented with headaches and left eye visual loss. Examination revealed acuity 20/20 OD and finger counting OS, a left afferent pupillary defect, papilledema OD, and optic atrophy OS. Left atrophy was unexplained until orbital MRI revealed left nerve compression by the gyrus rectus (figure, A), displaced by an intraventricular central neurocytoma (figure, B). Foster-Kennedy syndrome is characterized by optic atrophy on one side due to direct optic nerve mass lesion compression with contralateral papilledema. This case is termed pseudo-Foster-Kennedy with indirect compressive optic neuropathy due to brain displacement from a tumor distant from the optic nerve.1
Coronal T2-weighted orbital and brain MRI reveals left lateral ventriculomegaly with downward displacement of the gyrus rectus, resulting in left optic nerve compression (A), due to a left intraventricular mass (B).
Footnotes
Author contributions: Ninad Desai: manuscript writing and editing. Raymund Yong: conception of idea, manuscript writing and editing. Amish Doshi: manuscript writing and editing. Janet Rucker: conception of idea, manuscript writing and editing.
Study funding: No targeted funding reported.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- © 2015 American Academy of Neurology
Disputes & Debates: Rapid online correspondence
- Pseudo-pseudo-pseudo Foster Kennedy Syndrome
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