首诊眼科的颅内病变26例分析

Analysis of 26 patients with intracranial lesion consulting the oculist first

目的 :分析颅内病变的眼部表现及诊断方法。方法 :回顾分析 2 6例以眼部症状为主要表现而首诊于眼科的颅内病变。结果 :视力下降占 77% ,视野改变占 94 74% ,视神经萎缩占 34 70 % ,视盘水肿占 2 3 0 8% ,瞳孔改变占 18 73% ,眼肌麻痹占 19 2 3% ,误诊率 42 31% ,初诊误诊率较高。头颅CT或MRI有助于早期诊断 ,但较难发现较小的病变 ,视野检查可协助诊断。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。对可疑病例应根据症状。

Objective:To analyse the ocular manifestations in patients with intracranial lesion and the differential diagnostic methods.Methods:After thorough ophthalmologic and accessory examinations,the ocular conditions of 26 patients who consulted the oculist first were analysed.Results:The rates of visual disturbance,visual field defect,optic atrophy,papilloedema,mydriasis and ophthalmoplegia were 77%,94.74%,34.70%,23.08%,18.73% and 19.23% respectively.There was high misdiagnosis rate at first visit,and it was 42.31%.Conclusion:Visual pathway,oculopuillary reflex pathway and oculomotor nerves may be affected by the intracranial lesions,and develop ocular manifestations.CT or MRI is valuable and helpful to the early diagnosis,and visual field examinations may be helpful to the diagnosis of small intracranial lesion.