Falx Meningeoma Induced Optic Neuropathy—Clinical Manifestation and Differential Diagnosis: A Case Report

Purpose: Meningiomas are the most frequently diagnosed neoplasms. Ocular symptoms vary depending on size and localisation of the tumor, which is capable of compressing critical anatomic structures. Patients and Methods: A 44-year-old immunocompetent male was admitted to our hospital for further investigation of his bilateral optic disc swelling. A complete ophthalmological examination was performed including visual field assessment (VF), visual evoked potentials (VEP), fluorescein angiography (FLA) and magnetic resonance imaging (MRI). The patient had experienced only minor visual disturbances. Serological testing was performed. Results: Serological testing showed positive IgM and IgGtiters for cytomegalovirus (CMV) and subsequent imaging (MRI) revealed a frontal falxcerebri meningioma. Conclusions: We present a case of falx meningioma with overlapping serologically active CMV in an otherwise healthy and immunocompetent individual. Detailed differential diagnostic workup in immunocompetent individuals presenting with clinically unremarkable bilateral disc swelling is recommended.