CAJ | 학술논문

目的探讨外伤性视交叉损伤的病理机制及诊断治疗.方法对14例外伤性视交叉损伤的临床表现、影像学特点、手术治疗及随访进行研究.结果 14例病人中25只眼外伤后出现视力下降(双眼11例、单眼3例),双颞侧偏育10例,单眼颞侧偏肓4例.头颅CT示脑挫裂伤12例,头颅MRI检查11例均发现前颅窝底额叶眶直回脑挫裂伤.11例患者接受手术治疗,术后脑脊液鼻漏2例,随访6-36个月,平均13个月,10例14只眼术后视力提高、6例视野缺损有改善.3例未经手术治疗的患者,药物治疗视力皆提高,但视野无明显改善.结论视野检查颞侧缺损及头颅MRI检查是外伤性视交叉损伤诊断首选的检查,MRI检查显示有明显视交叉压迫者应该积极手术治疗.
목적 탐토외상성시교차손상적병리궤제급진단치료.방법 대14예외상성시교차손상적림상표현、영상학특점、수술치료급수방진행연구.결과 14례병인중25지안외상후출현시력하강(쌍안11례、단안3례),쌍섭측편육10례,단안섭측편황4례.두로CT시뇌좌렬상12례,두로MRI검사11례균발현전로와저액협광직회뇌좌렬상.11례환자접수수술치료,술후뇌척액비루2례,수방6-36개월,평균13개월,10례14지안술후시력제고、6례시야결손유개선.3례미경수술치료적환자,약물치료시력개제고,단시야무명현개선.결론 시야검사섭측결손급두로MRI검사시외상성시교차손상진단수선적검사,MRI검사현시유명현시교차압박자응해적겁수술치료.
Objective To investigate the pathogenesis, diagnosis and treatment of traumatic optic chiasm injury. Method Fourteen patients with traumatic optic chiasm injury were studied. An analysis was done on their clinical manifestation, image examinations, operations and prognosis. Results The visual acuity of 25 eyes (bilateral 11 cases, unilateral 3 cases) of 14 patients was decreased. Ten patients were bitemporal bemianopia. Four patients were unilateral temporal hemianopia. The brain contusion was found in 12 patients through cranial CT examination. The brain gyms rectus contusion in anterior cranial fossa was found in 11 patients through cranial MRI examination. Eleven patients received operations and two patients suffered from cerebrospinal rhinorrhea. All the patients were followed up from 6 to 36 months. The visual acuity of 10 patients was improved after operation. Among those who had visual field defect before operations, the visual fields of 6 patients had been improved, five had nothing changed. Three patients who did not have operations received medication. Their visual acuity was improved, but there was no obvious improvement for their visual field defect. Conclusions Visual field examination and cranial MRI are the preferred methods of the diagnosis of traumatic optic chiasm injury. Transcranial operation should be done for patients who have obvious optic chiasm compression in their MRI results.