Izumi Y, Udaka F, Nakamizo T, Ninomiya S, Kameyama M
Department of Neurology, Sumitomo Hospital Nakanosima, Osaka, Japan.
Rinsho Shinkeigaku. 1999 May;39(5):577-80.
The patient was a 47-year-old female. A giant meningioma was detected in the right middle cranial fossa by exploration for the cause of right-sided transient monoocular blindness of a 1-2 minute duration accompanied by headache. The headache was localized on the right side, occurred more frequently early in the morning, and continued for several hours. No neurological abnormality was noted except for right-side dominant bilateral choked disc and reduced vision. Both headache and transient monoocular blindness disappeared after total resection of the meningioma. A decrease in the cerebral blood flow associated with an increase in the intracranial pressure and right-sided occurrence of paroxysmal visual impairment due to choked disc were possible mechanisms of the transient monoocular blindness. Amaurosis fugax must be initially first in patients complaining of transient monoocular blindness, and exploration for carotid artery lesions is important. In the present case, however, this symptom led to detection of a giant meningioma.
患者为一名47岁女性。因右侧短暂性单眼失明持续1 - 2分钟并伴有头痛而进行病因探查时，在右侧中颅窝发现一个巨大脑膜瘤。头痛位于右侧，清晨发作更为频繁，持续数小时。除右侧优势性双侧视乳头水肿和视力下降外，未发现神经功能异常。脑膜瘤全切术后，头痛和短暂性单眼失明均消失。与颅内压升高相关的脑血流量减少以及因视乳头水肿导致的右侧阵发性视力损害可能是短暂性单眼失明的机制。对于主诉短暂性单眼失明的患者，必须首先考虑一过性黑矇，探查颈动脉病变很重要。然而，在本病例中，这一症状却导致了巨大脑膜瘤的发现。
