颅脑相关疾病导致眼球突出的临床分析  

Clinical analysis of exophthalmos caused by brain-related diseases

作　　者：宋宏鲁[1] 杜军辉[1] 王雨生[1] 胡丹[1] 

机构地区：[1]第四军医大学西京医院眼科,西安710032

出　　处：《中华实验眼科杂志》2011年第3期258-260,共3页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景眼球突出可由颅脑相关疾病引起，处置不当可引起严重后果，对患者症状和体征的综合分析有助于诊断。目的分析颅脑相关疾病引起眼球突出的病因及其临床表现。方法回顾性分析颅脑相关疾病引起眼球突出的住院患者38例的临床资料，其中男21例（55．26％），女17例（44．74％）；年龄16～71岁，平均37．21岁；右眼14例（36．84％），左眼21例（55．26％），双眼3例（7．89％）。结果38例患者按病因可分为4类：良性肿瘤25例（65．79％），恶性肿瘤2例（5．26％），颈动脉海绵窦瘘10例（26．32％），脑膜脑膨出1例（2．63％）。眼球突出度18～35mm，平均22．17mm。脑膜瘤患者可伴有长期头疼（65．22％）、恶心或呕吐（21．74％）、视力下降（17．39％）、眼压升高、视野缺损等表现。颈动脉海绵窦瘘患者均有不同程度的视力下降、搏动性突眼，听诊器可在耳际、眼眶上部听诊到心脏收缩期血流轰隆声；均伴有不同程度的眼球运动受限，其中8例（80％）患者眼睑水肿，球结膜充血，严重者结膜突出于睑裂外；8例（80％）患者伴有视物模糊、复视；6例（60％）患者伴有头疼。结论颅脑相关疾病患者可伴有眼球突出等眼部异常表现，分析其病史及临床表现可以为颅脑相关疾病的诊断提供有益的线索。Background Exophthalmos caused by brain-related diseases will result in the serious outcome if treated improperly. It will be helpful for the diagnosis of the disease correctly when signs and symptoms are taken into consideration. Objective This study was to analyze the cause and clinical manifestations of exophthalmos due to brain-related diseases. Methods The clinical data from 38 patients with exophthalmos caused by brain-related diseases was collected and analyzed retrospectively. The sex, age, cause, exophthalmos range, symptom and sign of patients were considered. Results The gender of 38 patients was 21 males（55.26% ） and 17 females（44.74% ） , aged from 16 to 71 years old with the average age 37.21. Four types of brain-related diseases were associated with the exophthalmos of eyeballs,including benign tumor 65.79% （ 25/38 ） containing the meningioma 60.53% （ 23/38 ） , ehordoma 5.26% （ 2/38 ） ; malignant tumor 5.26% （ 2/38 ） containing the malignant meningioma 2.63% （ 1/38 ） , choroid eong one cases of papillary carcinoma 2.63% （1/38）;carotid-cavernous fistula 26.32% （10/38）; meningoencephaloeele 2.63% （1/38）. Exophthalmos ranged from 18 to 35 mm in the patients with the average value of 22. 17 mm. In all of the 38 patients, the right eyes were 36.84% （ 14/38 ） , and left eyes were 55.26% （ 14/38 ） and bilateral eyes 7.89% （3/38）. Accompanying signs and symptoms of meningioma included long-term headache （ 65.22% ） , nausea and vomiting （ 21.74% ） , declined vision （ 17.39% ） , elevated intraocular pressure, visual field shrink and loss, etc.. Accompanying signs and symptoms of carotid cavernous fistula were loss of vision, pulsatile exophthahnos, noise over the orbit, ocular limitation of movement, eyelid edema （80%）, bulbar conjunctival congestion, episodes of eyelid, diplopia （ 80% ） , headache （ 60% ）. Conclusion Some brain diseases are often accompanied by exophthalmos. Exophthatmos can provide useful clues to the diagnosis of b

关 键 词：眼球突出 颅脑肿瘤 眼眶病 眼眶肿瘤 

分 类 号：R74[医药卫生—神经病学与精神病学]