Ernemann Ulrike, Freudenstein Dirk, Pitz Susanne, Naegele Thomas
Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Germany.
Graefes Arch Clin Exp Ophthalmol. 2002 Jul;240(7):575-7. doi: 10.1007/s00417-002-0503-x. Epub 2002 Jun 27.
The purpose of this study was to report the case of a patient with a saccular, intraorbital aneurysm of the ophthalmic artery and to analyze the correlation between clinical symptoms and aneurysm localization with regard to the literature.
We correlated the patient's clinical findings with anatomical substrates on magnetic resonance imaging and angiographic studies.
A 64-year-old woman presented with a rapidly progressive loss of visual acuity in her right eye, temporo-basal visual field defects, a temporal pallor of the optic disc and third and sixth nerve palsies. This apex orbitae compression syndrome was due to an aneurysm of the proximal intraorbital segment of the ophthalmic artery at a position inferolateral to the optic nerve, inferior to the third and medial to the sixth cranial nerve.
The symptoms caused by an aneurysm of the ophthalmic artery depend on its localization and spatial relationship to neural structures. While aneurysms of the intracranial and distal intraorbital segments may remain asymptomatic, those arising from the intracanalicular segment become clinically apparent with optic nerve conduction disorders. Aneurysms in the proximal intraorbital segment additionally provoke oculomotor disturbances due to compression of the third and sixth cranial nerves.
本研究旨在报告一例患有眼动脉囊状眶内动脉瘤的患者病例，并结合文献分析临床症状与动脉瘤定位之间的相关性。
我们将患者的临床检查结果与磁共振成像和血管造影研究中的解剖学基础进行了关联。
一名64岁女性患者出现右眼视力迅速进行性丧失、颞下象限视野缺损、视盘颞侧苍白以及动眼神经和展神经麻痹。这种眶尖压迫综合征是由眼动脉眶内近端段的一个动脉瘤引起的，该动脉瘤位于视神经的下外侧、动眼神经的下方和展神经的内侧。
眼动脉动脉瘤引起的症状取决于其定位以及与神经结构的空间关系。虽然颅内段和眶内远端段的动脉瘤可能无症状，但起源于眶内管段的动脉瘤会随着视神经传导障碍而在临床上显现出来。眶内近端段的动脉瘤由于压迫动眼神经和展神经，还会引发眼球运动障碍。
