Mariak Zofia, Obuchowska Iwona, Ustymowicz Andrzej, Sherkawey Nebi, Stankiewicz Andrzej
Kliniki Okulistyki Akademii Medycznej w Białymstoku.
Klin Oczna. 2002;104(5-6):384-90.
This study was undertaken to assess the pathogenesis of traumatic optic neuropathy as a consequence of closed head injury.
The clinical material comprised 34 patients (4 women and 30 men, age 14-70 years), who developed clinical symptoms of optic neuropathy after head trauma. A full ophthalmologic survey and colour Doppler examination of the orbital vessels were performed in all patients.
Full blindness of the affected eye, persisting since the injury, was noted in 20 patients. Orbital fracture was diagnosed in 15 person, but 4 patients among them had fracture of the optic canal bones. In 16 cases a retrobulbar hematoma was present. In 8 patients, who displayed no light perception after trauma, no flow was observed in the central retinal artery. In 18 other persons there was decreased of blood flow parameters. Only 6 patients had the normal flow in the orbital vessels.
The reason of the development of optic neuropathy after head injury is not clear. Our results of the blood flow measurement in the orbital vessels suggest, that disturbance of circulation within the optic nerve is very serious factor in the pathogenesis of traumatic optic neuropathy.
本研究旨在评估闭合性颅脑损伤导致外伤性视神经病变的发病机制。
临床资料包括34例患者（4例女性，30例男性，年龄14 - 70岁），这些患者在头部外伤后出现视神经病变的临床症状。对所有患者进行了全面的眼科检查和眼眶血管的彩色多普勒检查。
20例患者患眼完全失明，自受伤后一直持续。15例诊断为眼眶骨折，但其中4例伴有视神经管骨折。16例存在球后血肿。8例外伤后无光感的患者视网膜中央动脉未观察到血流。另外18例患者血流参数降低。只有6例患者眼眶血管血流正常。
头部损伤后视神经病变的发生原因尚不清楚。我们对眼眶血管血流测量的结果表明，视神经内循环障碍是外伤性视神经病变发病机制中的一个非常重要的因素。
