Abstract
Background: The examination of cognitive function in individuals with disabilities is still a challenge for neurobehavior practitioners. It is caused by the lack of sensory impulses, and it is also related to individual responses and the interpretation of the examination. Cognitive examination for visual impairment is still developing at this moment.
Case Report: A 34-year-old woman complained of a progressive chronic headache for two years before her visit. She also complained of a blurred vision that deteriorated to blindness. The patient was currently on her fourth pregnancy with a nine-month gestational age. On neurological examination were found bilateral anosmia, visual acuity of no-light-perception on both eyes with papillary atrophy. Head MRI with contrast showed an extra-axial mass in suprasellar. Tumour biopsy showed a WHO grade I fibrous meningioma. The value of MoCA-Blind in the patient was 16 (cognitive impairment), while MMSE for Sensory Deficit was 22 (mild cognitive impairment). Impairment in more than one cognitive domain was also found in this case.
Discussion: Cerebral tumours can affect cognitive function through various mechanisms. One study found that the majority of patients with cerebral tumours had impaired at least one area of cognitive function. Cases of cerebral tumours with blindness sometimes were found in daily practice. Cognitive testing ideally requires a normal vision, so we need an adjusted instrument, such as MoCA-Blind and MMSE for Sensory Deficit.
Conclusion: Cognitive function needs to be evaluated in cases of cerebral tumours, especially if accompanied by disabilities. Further studies on adjusting the total value and interpretation of examinations are required to determine the instrument's validity.

Key words: meningioma, cerebral tumor, blindness, cognitive, MoCA-Blind, MMSE