脑血管介入术后皮质盲的临床分析

Acute transient cortical blindness occurring after cerebral angiography and vascular interventional management:a clinical analysis

目的探讨脑血管造影和介入治疗术后一过性皮质盲的诊断、可能的病因及预防措施。方法 2007年8月至2012年8月对2 547例患者行脑血管造影和介入治疗,筛选出术后出现皮质盲的患者共8例次,并对患者的临床资料进行分析。结果行脑血管造影和介入治疗共2 547例患者,其中8例次术后出现了一过性皮质盲,平均对比剂用量107 ml。所有患者经治疗后症状消失,预后良好。结论为了减少造影术后皮质盲发生率,应尽量减少造影时间,常规使用非离子型对比剂,降低对比剂使用总量。

Objective To discuss the diagnosis, the possible etiologic factors and the corresponding prevention measures of the cortical blindness that occurs after cerebral angiography and vascular interventional management. Methods During the period from August 2007 to August 2012, cerebral angiography and vascular interventional management were carries out in 2 547 patients. Among the 2 547 cases, postoperative cortical blindness occurred in 8 cases. The clinical data were analyzed. Results After cerebral angiography and vascular interventional management, 8 cases developed transient cortical blindness, and the mean amount of contrast medium used in the performance of cerebral angiography and intervention was 107 ml. After medication the clinical symptoms disappeared completely, and all the patients recovered well. Conclusion In order to reduce the occurrence of cortical blindness after cerebral angiography and intervention, it is necessary to reduce the operation time, to employ non-ionic contrast medium and to use the contrast medium as little as possible.（J Intervent Radiol, 2013, 22： 008-011）