辐射后的视神经病变
Edward Margolin1, Armin Handzic2,3
1University of Toronto, Faculty of Medicine, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada Edward.margolin@uhn.ca.
Practical neurology
|September 10, 2024
概括
一位患者经历了下垂体手术和放射治疗后的连续视力丧失. 这一案例突出了辐射后视神经病变,这是辐射治疗后影响视神经的疾病.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 辐射瘤学 辐射瘤学
背景情况:
- 垂体腺瘤可以引起视觉障碍.
- 放射治疗有时被用作在手术切除垂体腺瘤后的辅助治疗.
- 视神经病变是辐射疗法在视觉通路附近的潜在并发症.
研究的目的:
- 描述一个连续视力丧失的案例.
- 为了诊断辐射后的视神经病变.
- 讨论这种疾病的病理生理学和潜在的治疗方法.
主要方法:
- 一个中年男子双边视力丧失的案例报告.
- 医学史的审查,包括垂体腺瘤切除和放射治疗.
- 磁共振 (MR) 对大脑和轨道的成像与对比.
- 大脑脊髓液分析.
主要成果:
- 患者在两只眼睛中出现了亚急性,无痛的视力损失.
- 核磁共振成像显示,这两种视神经的前神经段的增强.
- 鉴定出1.5年前曾经接受过垂体放射治疗的病史.
- 诊断为辐射后的视神经病变.
结论:
- 辐射后视神经病变会导致严重的,连续的视力丧失.
- 病理生理学涉及视神经神经管的辐射诱导的内皮病变.
- 高压氧气疗法可能是一个有前途的治疗方法,如果早期启动.
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