颅内动脉瘤栓塞术后失明案一则

A case of blindness after intracranial aneurysm embolization

颅内动脉瘤又称脑动脉瘤,是指由于动脉硬化、感染、创伤等原因导致局部血管异常改变而产生的脑血管瘤样突起,其发病率居脑血管意外患者中第三位。瘤体无破裂或瘤体体积较小的患者通常无症状;若瘤体破裂或压迫周围组织可导致脑出血、脑缺血、麻痹等表现,严重者可有生命危险。案例中患者失明为颅内动脉瘤栓塞术后引起的并发症,属于中医“暴盲”范畴。案例中患者通过采用益气明目、醒脑开窍、活血通络的治疗法,运用揿针压埋彭氏眼穴联合醒脑开窍针刺法为主进行治疗,取得较好的疗效。治疗中醒脑开窍针刺法对脑血管病、肢体障碍的患者亦有明显的促进及协调作用,眼针治疗联合体针配穴光明穴、养老穴,使机体三焦通利,气血调和,以达到改善眼周的血液供应,解除视神经压迫,恢复视力的目的。文章将本案详细诊疗经过进行报告,以期为临床提供参考。

Intracranial Aneurysm,also known as cerebral aneurysm,refers to cerebral angioma like protrusions caused by abnormal changes of local blood vessels due to arteriosclerosis,infection,trauma and other reasons.Its incidence rate ranks third among cerebrovascular accident patients.Patients with nonruptured tumors or small tumors usually have no symptoms.If the tumor body ruptures or compresses the surrounding tissues,it may lead to cerebral hemorrhage,cerebral ischemia,paralysis and other manifestations,which may be life threatening in severe cases.The blindness of the patient in the case is a complication caused by the embolization of intracranial aneurysms,which belongs to the category of sudden blindness in TCM.In the case,the patients were treated by supplementing Qi(气)and brightening eyes,activating blood circulation and unblocking collaterals,The treatment was mainly carried out by thumb-tack needle for subcutaneous embedding on PENG's eye points plus consciousness restor resuscitat acupuncture,and achieved good results.Eye acupuncture treatment combined with body acupuncture points of Guangming(GB37)and Yanglao(SI6),so that Sanjiao(三焦)can be eased,Qi and blood harmonized,so as to improve the blood supply around the eyes,relieve optic nerve compression,and restore vision.This article reports the detailed diagnosis and treatment of this case,with a view to providing reference for clinical practice.