Objective: To investigate the ocular manifestations of brainstem tumors and to avoid misdiagnosis and missed diagnosis.
Methods: This is a retrospective case series study. The clinical data of 57 brainstem tumor in-patients were collected from 1993 to 2007. The clinical manifestations and the results of related examinations were analyzed.
Results: The present series included 51 cases of brainstem germinoma, 4 cases of cavernous hemangioma, 1 case of hemangioblastoma and 1 case of metastatic tumor. In 51 cases of brainstem germinoma, there were 37 males and 14 females. The first attack age varied from 5 to 55 years old and the median age was 23 years old. The high incident ages of brainstem germinoma were 10 - 35 years. Patients were presented with diplopia, ocular motility disturbance, nystagmus, anisocoria, and facial palsy. In 57 patients, diplopia was the initial symptom in 12.3% (7/57) cases. The incidence of oculomotor nerve paralysis was 17.5% (10/57); trochlear paralysis, 1.8% (1/57); trigeminal nerve paralysis, 5.3% (3/57); abducens nerve paralysis, 35.1% (20/57); facial palsy, 14.0% (8/57); optic disc edema, 19.3% (11/57); nystagmus, 21.1% (12/57) and anisocoria, 10.5% (6/57).
Conclusions: Ocular manifestations occur frequently in brainstem tumor. Nuclear ophthalmoplegia, nystagmus and other neuro-ophthalmic signs provide helpful clues for the diagnosis of brainstem tumor.