Presentation
Right eye loss of vision.
Patient Data
The right gyrus rectus shows thick gyri with blurred cortico-white matter junction, in keeping with focal cortical dysplasia.
Gyrus rectus herniation compressing the right optic nerve at its prechiasmatic segment eliciting low T1 signal.
Case Discussion
The gyrus rectus is located in the floor of the anterior cranial fossa superior to the prechiasmatic optic nerves and the optic chiasm.
Herniation of the gyrus rectus can be idiopathic or secondary to a mass or dysplastic growth as in our case (focal cortical dysplasia).
This subsequently causes compression of the ipsilatertal optic nerve and optic nerve neuropathy.
Coronal images are the best to identify gyrus rectus herniation and the ipsilateral optic neuropathy evident by thinning and increased signal of the nerve.
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