脑血管介入诊疗术后致皮质盲的临床分析  

Clinical analysis and review of the literature of cortical blindness after cerebral angiography

作　　者：李建涛[1] 孙学东[1] 李生[2] 肖玉良[3] 王君[2] 

机构地区：[1]威海市立医院神经外一科,山东威海264200 [2]解放军总医院神经内科,北京1008533 [3]泰山医学院药学院,山东泰安271000

出　　处：《泰山医学院学报》2015年第9期975-977,共3页Journal of Taishan Medical College

基　　金：山东省自然科学基金联合专项(ZR2011HL052);山东省高等学校科技计划项目(J15LM08)

摘　　要：目的讨论血管造影和/或介入治疗术后皮质盲的病因、诊断、治疗和预防措施。方法回顾性分析我科5965例脑血管介入诊疗患者中,以皮质盲为主要表现的4例患者的病史、检查过程、术后症状表现、治疗方法、相关辅助检查资料、治疗结果。结果患者神经眼科检查未见异常,颅脑CT均未见明显颅内埂塞和出血表现。经过扩容、缓解血管痉挛、改善脑灌注压、稳定血脑屏障、神经营养、改善脑代谢、清除自由基以及心理疏导等对症治疗,4例患者皮质盲在11天内完全恢复,随访3个月未见相关并发症。结论数字减影血管造影术(DSA)术后皮质盲是少见并发症,但经过对症处理,多数预后良好;工作中应提高认识,降低发生率。Objective：To analyze the pathogeny of the cortical blindness caused by cerebral angiography. Methods：The analysis was made of the clinical data of the 4 case of postoperative cortical blindness from 5965 cases of the cerebral angi-ography during from January 2008 to December 2014. Results：No pathologies were found,and cranial computed tomo-graphy showed no intracranial infarcts and hemorrhage in the ophthalmologic and neurologic examination. Treatment includ-ed the alleviation of vasospasm,improvement of cerebral perfusion pressure,stable blood brain barrier and neural nutrition, improvement of cerebral metabolism,free radical scavenging and psychological counseling symptomatic treatment. Four pa-tients with cortical blindness were recovered in 11 days. There were related complications in the 3 follow-up months. Con-clusion：The cortical blindness,caused by cerebral angiography,is a rare complication,and most patients can be cured.

关 键 词：皮质盲 动脉瘤 造影 脑血管造影 枕叶 可逆 

分 类 号：R743[医药卫生—神经病学与精神病学]