创伤性双边核间眼膜与加症综合征
Somapika Devi Oinam1, Puja Hingorani-Bang2
1Ophthalmology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India somapikaoinam@gmail.com.
BMJ case reports
|November 29, 2024
概括
一次创伤性脑损伤导致了微妙的双边核内眼,一种罕见的眼动障碍. 这一案例凸显了识别这种情况的重要性,即使没有典型的症状,如双重视力.
科学领域:
- 神经科学是一个神经科学.
- 眼科医生 眼科 眼科
- 创伤学 创伤学 创伤学
背景情况:
- 一名年轻的男性患者因跌倒而遭受头部和身体创伤.
- 创伤后一个月,右眼间歇性向外偏差被注意到,没有双眼视.
- 神经学检查显示了双边引力缺陷和鼻.
研究的目的:
- 报告一个双边核内眼 (INO) 的独特病例,在创伤性脑损伤后呈现微妙.
- 讨论创伤性出血后的INO诊断挑战和潜在的恢复.
主要方法:
- 临床病例介绍和诊断成像.
- 患者接受了MRI (平面) 检查,结果显示在中脑后部和小脑中部有血红素染色的旧血瘤,影响了中间纵向带.
- 开始了保守的管理和密切的跟进.
主要成果:
- 核磁共振扫描证实大脑干中有一个旧的血瘤,影响了中间纵向带,与INO的原因一致.
- 患者的INO呈现出没有明显的外otropia或diplopia,导致诊断延迟.
- 对于保守管理的患者,采用了保守管理.
结论:
- 双边内核眼膜的微妙表现可能难以诊断,尤其是在创伤后发生时.
- 虽然因其他原因引起的INO可能会消失,但因创伤后慢性血液瘤引起的INO可能会有长期或不可逆转的过程.
- 这一案例强调了在有头部创伤史和微妙眼动异常的患者中进行彻底的眼科和神经学评估的必要性.
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