首诊眼科的颅内病变诊断分析

Analysis of intracranial lesions primarily diagnosed by ophthalmologic examination

目的 分析颅内病变的眼部表现及诊断方法。方法 分析 2 2例首诊于眼科的颅内病变的眼部表现及辅助检查 ,初诊与确诊对照分析。结果 本组中 ,有视力下降占 81.8% ,视野改变占 89.5 % ,视盘水肿占 40 .9% ,视神经萎缩占 5 0 % ,瞳孔改变占 2 2 .7% ,眼肌麻痹占 18.2 % ,初诊误诊率较高。头颅 CT或 MRI有助于早期诊断 ,但较难发现较小病灶。结论 颅内病变可以通过影响视路、瞳孔光反射路及眼运动神经而表现各种眼部症状。对可疑病例应根据神经定位体征及时行针对性头颅 CT或 MRI等检查。

Objective Retrospectively analyse the ocular manifestations of intracrainal lesions and diagnostic methods.Methods 22 patients came to the ophthalmology department first.After ophthalmologic examination and accessory examination,they were diagnosed as intracrainal diseases.We analyse the preliminary diagnosis and confirmed diagnosis.Results The ocular manifestations of 22 cases were reported.They were visual disturbance (81.8%),visual field defect (89.5%),papilloedena (40.9%),optic atrophy (50%),mydriasis (22.7%) and diplopia (18.2%).There is high misdiagnosis rate at first visit.CT ofr MRI is helpful to the early diagnosis,but it is difficult to find small lesions.Conclusions Visual pathway,oculopuillary reflex pathway and oculomotor nerves might be affected by pressure to develop ocular manifestations.CT or MRI is valuable for those unconfirmed cases according to orientation signs.