Masquerade - Video

A 68 year-old man from Nicaragua, with a past medical history of diabetes and hypertension, presented with a one-year history of right-sided headaches, diplopia, and a four-month history of sudden vision loss in his right eye. In Nicaragua, a head CT and an angiogram had revealed a sphenoid wing and cavernous sinus lesion, suspected to be a meningioma, as well as occlusion of the right internal carotid artery. He was sent to the United States for possible radiation treatment. At the time of presentation in the United States, the patient also reported involvement of the left eye. He had no light perception in the right eye and a constricted visual field in the left eye. A right afferent pupillary defect was noted, along with decreased sensation in the V1 distribution on the right side. A procedure was performed