一个案例报告的冠状动脉洞:一个常常错过的诊断
Rosalind Wu Ma1, Dustin Harris1
1University of Texas at Southwestern, Department of Emergency Medicine, Dallas, Tx.
Journal of education & teaching in emergency medicine
|February 9, 2026
概括
轨道区综合征 (OCS) 可能具有非典型的表现. 頸動脈洞導致慢性OCS症狀,突顯了在非創傷性病例中需要進行徹底的血管評估的必要性.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 血管外科 血管外科
背景情况:
- 轨道综合征 (OCS) 是一种眼科紧急情况,通常是由创伤引起的,导致轨道内压力增加和潜在的视力丧失.
- 亚急性或慢性OCS表现可以模仿其他疾病,使诊断和管理复杂化.
- 错误诊断可能会推迟适当的治疗,增加永久视力损伤的风险.
研究的目的:
- 报告一个副急性轨道隔间综合征 (OCS) 的病例,该病例是 carotid cavernous fistula (CCF) 的次要病例.
- 为了说明非创伤性OCS的诊断挑战和管理.
- 强调在非典型的OCS病例中考虑血管病因的重要性.
主要方法:
- 一个48岁的男性的病例报告,有6个月的眼睛疼痛和胀史.
- 最初的治疗包括局部和口服类固醇,改善程度有限.
- 诊断工作包括眼科检查,眼内压力 (IOP) 测量和磁共振血管学 (MRA).
主要成果:
- 磁共振血管造影 (MRA) 揭示了一个左动脉洞穴囊 (CCF).
- 通过降低内血压的眼滴和阿西塔佐胺的医疗管理导致症状改善.
- 成功的CCF栓塞导致IOP的正常化和症状的消失.
结论:
- 非创伤性原因,如CCF,可以呈现为亚急性OCS,导致误诊.
- 在亚急性OCS中,可能会推迟出现的外科减压,有利于针对潜在血管病变的向治疗.
- 综合性血管评估对于诊断和管理非典型的OCS表现至关重要.
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