外伤性视交叉损伤（附4例报告）  

Traumatic Optic Chiasma Injury

作　　者：康元宝[1] 方志敏[1] 宋建华[1] 陈建宁[1] 

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《医学信息》2012年第8期157-158,共2页Journal of Medical Information

摘　　要：目的探讨外伤性视交叉损伤的发病机制及诊断治疗。方法对4例外伤性视交叉损伤的发病机制、临床表现、影像学特点、手术治疗及预后进行研究分析。结果4例患者伤后皆出现视力视野的损害，其中双眼视力下降3例，单眼视力下降1例，双眼颞侧视野缺损3例，单眼颞侧视野缺损1例。头颅CT检查提示4例患者皆伴有脑挫裂伤及前颅底骨折，颅脑MRI检查提示均存在额叶眶直回脑挫裂伤压迫视交叉。4例患者均接受了手术治疗，1例术后出现脑脊液鼻漏。术后随访6～62个月，平均30个月，3例5只眼术后视力提高，2例术后视野明显改善。结论外伤性视交叉损伤少见，多见于颅脑损伤较严重者。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。Objective To investigate the pathomeehanism, the diagnosis and treatment of traumatic optic chiasm injury. Methods Four patients with traumatic optic ehiasm injury were studied. An analysis was done on their clinical manifestation, inaageology examinations, operations and prognosis. Results Visual acuity was decreased in all patients. Three patients are bitemporal hemianopia. All the patients were found brain contusion through cranial CT examination. All the patients were clone through cranial MR[ examination and were all found brain gyrus rectus contusion in anterior cranial fossa. All the patients received operations and one patient suffered from cerebrospinal rhinorrhea. All the patients were follow up for 6-62 months. Three patients＂ visual acuity and two patients＂ visual field were improved after operations. Conclusions Traumatic optic chiasm injury is rare. It often occurs in patients with severe cranioeerebral injury. Visual field examination and MRI are the preferred methods of its diagnosis. Patients who have obvious optic chiasm compression in their MRI results should get operations.

关 键 词：视交叉损伤 颞侧偏盲 经颅手术治疗 

分 类 号：R774.6[医药卫生—眼科]