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Irreversible aneurysm-like ectasia of the optic nerve sheaths in a patient with bilateral subdural hematomata

The differential diagnosis of retrobulbar processes as detected by computed tomography or magnetic resonance imaging (MRI) comprise a variety of pathological processes. While the most frequent diagnoses are tumours or inflammation, others are incidental findings that might point to an underlying cause. Among the latter is enlargement of the optic nerve sheath, an expansion of the cerebrospinal fluid space around the optic nerve that in some cases is linked to raised intracranial pressure.1

The so called “optical nerve sheath ectasias” or meningoceles are a rare finding, with only around 40 documented patients.2 3 The appearance of these ectasias has been described as tube-like. Aneurysm-like ectasias of the optical nerve sheath …