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Neurology:浣熊眼不要忽视了眼动脉动脉瘤

2019-05-31 佚名 脑血管病及重症文献导读

73岁,女性。既往高血压和糖尿病病史。表现为突发头痛和右侧眶周瘀斑。

73岁,女性。

既往高血压糖尿病病史。

表现为突发头痛和右侧眶周瘀斑(下图):



否认外伤病史。

查体未见阳性体征。

眼科检查显示视力正常,眼球运动正常,无视乳头水肿及视网膜出血。

CTA 显示右侧眼动脉动脉瘤 SAH。下图 B,CT 显示 SAH;图 C 和 D 显示右侧眼动脉分叶状(bilobar)动脉瘤:







随后成功血管内治疗,症状完全恢复。

最终作者认为动脉瘤位于海绵窦,破裂后引起海绵窦和眶(周)静脉静脉压迅速升高,最终引起眶周瘀斑。除了颅骨骨折和海绵窦血栓形成以外,SAH 是突发严重头痛伴眶周瘀斑的另一个重要鉴别诊断

原始出处:Aalbers M, van Dijk JMC. Teaching NeuroImages: Raccoon eye in subarachnoid hemorrhage. Neurology. 2019 Mar 26

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