SUPRASELLAR MENINGIOMA AND BLINDNESS - A UNIQUE EXPERIENCE IN SAUDI-ARABIA

BACKGROUND The natural history of intracranial meningioma is no differ ent in the Arabian peninsula than in other countries. The extent of th e total loss of vision in one or both eyes, however, is unique to this area. METHODS A retrospective study was conducted at King Faisal Spec ialist Hospital and Research Centre, a tertiary care institution in Sa udi Arabia, on all cases of intracranial meningioma seen over a period of 9 years. The following data were collated: clinical presentation, site and size of tumor, radiologic features, surgical methods, and pre operative and postoperative visual status. RESULTS Seventy of 232 case s (30.1%) of intracranial meningioma presented in the suprasellar area ; the majority of these were more than 5 cm in diameter. Because of th e large size it was not always possible to identify the exact point of origin or to achieve complete tumor removal. Deteriorating vision was the cardinal presenting feature and the incidence of blindness in one or both eyes at presentation was high (42.2%); 12.8% were totally bli nd on admission. None of these patients showed improvement after surge ry (complete or subtotal removal of tumor). CONCLUSION Lack of underst anding of the symptoms and cultural influences are direct contributing factors to this complication of a benign intracranial lesion. This re presents a serious public health concern in the Arabian peninsula.