神经眼科体征在重症脑干梗死的临床意义

目的观察神经眼科体征在危重脑干梗死病例中临床价值。方法分析19例经尸检确诊的脑干梗死患者神经眼科体征类型与梗死部位及预后的关系。结果18例出现眼科体征,表现为各类眼震,颅神经麻痹、瞳孔大小异常、同向凝视麻痹、霍纳综合征和核间性眼肌麻痹等。其中出现2种或以上的复合眼征共13例。累及中脑、桥脑或延脑的复合病灶有12例,有中脑病灶者均出现神经眼征。结论观察记录神经眼科体征对危重脑干梗死的定位诊断和评估病情有重要价值。

Clinical significance of neuro-ophthalmic signs in critical brainstem infarction

Objective To focus on significance of neuro-ophthalmic signs in evaluating critical brainstem infarction.Methods Types of neuro-ophthalmic signs and their relationship to location of 19 cases with autopsy-proven brainstem infarction were analysed retrospectively.Results 18 cases presented with neuro-ophthalmic signs including variform nystagmus,cranial nerve palsy ,mydosis or mydriasis, horizontal or vertical gaze palsy,Horner's syndrome and internuclear ophthalmoplegia.2 or more types of compound eye-mvement signs were observed in 13 cases.12 cases suffered from extensive infarctions which involved midbrain and pons or midbrain,pons and medulla oblongata.All cases with midbrain infarction were accompanied by neuro-ophthalmic signs.Conclusions Neuro-ophthalmic signs is contributive to determine locations of critical brainstem infarction and to evaluate prognosis.