案例报告:异常的视觉表现是由大凸性脑膜瘤引起的 - - 一种神经伸展和茎缩效应
Chia-Hsun Chiu1, Ko-Ting Chen2,3,4
1Department of Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.
Frontiers in surgery
|August 2, 2024
概括
大脑瘤可以通过增加内压力 (IICP) 引起视力问题,而不仅仅是直接压缩视神经. 这一案例凸显了IICP和脑膜瘤如何导致异常视野缺陷.
科学领域:
- 神经学 神经学
- 眼科医生 眼科 眼科
- 神经瘤学神经瘤学
背景情况:
- 视野缺陷在脑瘤患者中很常见,通常是由于直接的光通路压缩.
- 瘤可以通过间接机制引起视觉症状,例如增加内压力 (IICP),尽管报告较少.
研究的目的:
- 为了研究在没有直接光路压缩的情况下,脑瘤患者视野缺陷的潜在机制.
- 提出一个案例研究,说明由脑膜瘤和IICP引起的异常视野缺陷.
主要方法:
- 一个32岁的男性的病例报告,视力模糊.
- 对右凸性脑膜瘤的诊断.
- 对磁共振图像进行审查,以分析瘤对光学结构和内压力的影响.
主要成果:
- 患者呈现右侧视力模糊,并被诊断为右凸性脑膜瘤.
- 磁共振成像表明在视觉和视觉神经伸展上存在垂体茎的缩.
- 这些发现,加上焦点内压的增加,被假定是导致异常视野缺陷的原因.
结论:
- 大脑瘤可以通过间接机制诱导视野缺陷,包括增加内压力.
- 脑膜瘤,即使没有直接的压缩,也可以通过质量效应和相关的IICP导致视觉障碍.
- 需要进一步研究脑瘤患者视力损伤的间接机制.
相关概念视频
01:14Increased Intracranial Pressure l: Introduction
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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
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01:29Increased Intracranial Pressure ll: Pathophysiology
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Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
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