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The aim of the present study was to observe visual pathway changes on the contralateral side in optic nerve sheath meningioma (ONSM). The authors present a case report of a 43-year-old patient with OfNSM on the right side. A complex ophthalmic examination was performed, including an assessment of visual functions, an electrophysiology examination and functional and structural MRI examinations. Visual acuity of the right eye after ONSM remained with no light perception, while that of the left side was normal. The visual field of the left eye was normal as was colour perception. An electrophysiology examination using a pattern electroretinogram revealed low amplitude values in the right eye. In the left eye, the finding was at the lower limit of normal results. The pattern visual evoked potential exhibited a bilateral lesion with a larger decrease in response after stimulation of the right eye. The structural MRI revealed intraorbital atrophy of the optic nerve on the right side throughout the whole course, which was accompanied by atrophy of the right half of the optic chiasm. Functional magnetic resonance imaging revealed zero activity after stimulation of the right eye and decreased activity in the visual centre after stimulation of the left eye. The present study demonstrated that unilateral damage to the optic nerve in ONSM is accompanied by significant changes on the contralateral side of the optic pathway.

The present study reports a case of a 44-year-old female patient with a large frontal lobe tumor who underwent surgery using a modern navigation system SonoWand that combines the advantages of a non-frame navigation system with intraoperative real-time ultrasound imaging. The right frontal lobe tumor consisted of two morphologically different sections. A diffuse astrocytoma grade II and a glioblastoma grade IV were identified. These tumors were relatively substantially separated. A 17 p deletion, including TP53, was detected in a diffuse astrocytoma but not in a glioblastoma. EGFR and MDM2 amplifications were detected only in a glioblastoma. Detection of these amplifications is typical for primary glioblastomas. These findings support our assumption of two independent tumors. The KRAS, BRAF and EGFR gene mutations were also detected in a glioblastoma. Such an accumulation of molecular mutations is rare in one tumor. Following oncological treatment the patient was cared for in the oncological center and survived for 15 months after the surgery without any signs of a disease. This is an unusual case, and to the best of our knowledge, is not frequently published in literature.