一个独特的压缩性视神经病变的案例来自内部动脉动脉瘤
Daniel S Boyes1, Kiren Bashir1, Jonathan M Skarie2,3
1Wright State University Boonshoft School of Medicine, Fairborn, Ohio, USA.
Case reports in ophthalmological medicine
|November 3, 2025
概括
由大内动脉动脉瘤引起的双边压缩性视神经病变 (CON) 的罕见病例突出显示,可能缺少相对附带瞳孔缺陷 (RAPD). 视觉现场测试对于在没有RAPD的情况下诊断CON至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 压缩性视神经病变 (CON) 是由于对视神经的机械压力造成的.
- 双边CON不常见,通常呈现出微妙或不典型的临床症状.
- 内动脉动脉瘤很少会通过压缩引起视神经病变.
研究的目的:
- 报告一种罕见的双边CON病例,该病例是二次发生的大型上内动脉动脉瘤的.
- 强调在CON中视野测试的诊断实用性,特别是当相对附带瞳孔缺陷 (RAPD) 不存在时.
- 为了说明在视力丧失的情况下,区分中枢神经系统病变与外周病变的重要性.
主要方法:
- 一个66岁的女性病例报告,视力敏度下降和头痛.
- 临床检查,包括对RAPD的评估.
- 正式视野测试用于识别视野缺陷.
- 磁共振成像 (MRI) 来确定潜在的原因.
主要成果:
- 患者出现间歇性头痛和视力敏度下降.
- 没有观察到相对附带瞳孔缺陷 (RAPD).
- 视野测试揭示了右眼的下部高度缺陷和左眼的超时缺陷,暗示了结节性阴影瘤.
- 核磁共振扫描证实了右侧上内动脉的大型动脉瘤.
结论:
- 没有RAPD并不排除CON,特别是在双边情况下.
- 视觉现场测试对于诊断CON和区分中心和外围病变至关重要.
- 大型动脉瘤可能是压缩性视神经病变的罕见原因,需要及时诊断和管理.
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