Hahn C D, Nicolle D A, Lownie S P, Drake C G
Division of Neurology, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
J Neuroophthalmol. 2000 Dec;20(4):253-8.
To review the presenting symptoms and ophthalmic findings of 57 patients with cavernous carotid aneurysms of giant size (> or = 2.5-cm diameter).
Hospital charts of 57 patients with giant cavernous carotid aneurysms who presented to University Hospital in London, Ontario, Canada between 1961 and 1993 were reviewed. All patients were proven by cerebral angiography to have unruptured giant cavernous carotid aneurysms.
Forty-six patients (81%) were women (mean age, 54 years). The most common presenting symptoms were diplopia (89%), retroorbital pain (61%), headache (19%), diminished or blurred vision (14%), and photophobia (4%). The most common clinical sign was partial or complete ophthalmoplegia (93%). Trigeminal nerve involvement was found in 37% of patients. Other clinical signs included ptosis, decreased visual acuity, proptosis, and visual field defects.
This study characterizes a large group of patients with giant cavernous carotid aneurysms seen over a 30-year period at a single institution. As in previous studies, diplopia and retroorbital pain were the most common symptoms. The high incidence of ophthalmoplegia observed in this study may be explained by a greater compressive and/or ischemic effect of giant aneurysms compared with their smaller counterparts.
回顾57例巨大型海绵窦段颈动脉瘤（直径≥2.5 cm）患者的临床表现及眼科检查结果。
回顾了1961年至1993年间就诊于加拿大安大略省伦敦市大学医院的57例巨大型海绵窦段颈动脉瘤患者的病历。所有患者经脑血管造影证实为未破裂的巨大型海绵窦段颈动脉瘤。
46例（81%）为女性（平均年龄54岁）。最常见的临床表现为复视（89%）、眶后疼痛（61%）、头痛（19%）、视力减退或模糊（14%）以及畏光（4%）。最常见的临床体征为部分或完全性眼肌麻痹（93%）。37%的患者发现有三叉神经受累。其他临床体征包括上睑下垂、视力下降、眼球突出和视野缺损。
本研究描述了在一家机构30年间所见到的一大组巨大型海绵窦段颈动脉瘤患者的特征。与以往研究一样，复视和眶后疼痛是最常见的症状。本研究中观察到的眼肌麻痹高发生率可能是由于巨大动脉瘤与其较小的同类动脉瘤相比具有更大的压迫和/或缺血效应所致。
