颅脑损伤合并视觉功能障碍

目的探讨颅脑损伤后视觉障碍的分型和处理对策。方法对1993年3月~1999年12月间颅脑损伤后合并视觉功能障碍的82例病历资料进行回顾性的分析。结果(1)意识障碍影响视力下降/失明、复视、视野缺损诊断的建立;(2)X线平片对视神经损伤的诊断作用有限,CT阳性率可达观60%以上;(3)29例经手术治疗,有效率83.3%,其余52例均采用药物为主的治疗方法,痊愈率达90%以上。结论(1)视觉功能的障碍发生与颅脑伤的轻重程度不完全一致,意识障碍严重时,易忽略视神经损伤诊断,额颞部和前颅凹陷性骨折常并发视神经损伤;(2)视神经管内段损伤导致视觉障碍多需要手术治疗;(3)复视常见,但多数预后较好;视野缺损在重症颅脑损伤后继发性枕叶损害最多见。

Craniocerebral injuries with dysopia:a report of 82 patients

Objective To analyse the types and treatments of dysopia after severe craniocerebral injuries.Methods To study The dlinical date of 82 patients of severe craniocerebral injuries with dysopia from March 1993 to December 1999 were analyzed retrospectively.Results(1)Consciousness barrier troubles the diagnosis of poor eyesight,blindness,double vision and vision disfigurement.(2)X-ray does not take an important part in the diagnosis of optic nerve injuries.Positive rate of CT examination reaches over 60%.(3)29 patients are treated well through operation,and the effectiveness is 83.3%.The effectiveness of the other patients is over 90% by curing with medicine.Conclusion(1)The severity of craniocerebral injuries does not match that of the dysopisa.When the consciousness barrier is serious,it is easy to ignore the diagnosis of optic nerve hurt.Sunk fracture at the frontaltemporal part and anterior cranial fossa usually causes the injury of optic nerve.(2)The vision barrier caused by the harm of inner optic nerve pipe needs to be operated.(3)Double vision happens to the patients easily,but most of them have good prognosis.The secondary harm at occipital lobe usually accompanies by vision disfigurement.