Hasenböhler E, Conti M, Martinoli S, Landau K
Departement für Chirurgie, Ospedale Civico, Lugano, Schweiz.
Unfallchirurg. 2004 Jun;107(6):521-4. doi: 10.1007/s00113-004-0755-5.
Blindness can be the consequence of trauma, which until now had only been described in cases involving direct facial or cranial trauma. In our case a 53-year-old street worker became irreversibly blind after a thoracoabdominal compression trauma. The investigations performed were inconclusive regarding the cause of blindness. We postulate a massive increase in venous blood pressure with capillary stasis and consequent optic nerve damage. Fat emboli syndrome or posterior ischemic optic neuropathy could be causes, but unrealistic for this case. It still comes into question why such a mechanism has not been seen in other blast injury cases. In the end, the additional factor that resulted here in complete irreversible blindness remains unclear.
失明可能是创伤的后果,此前仅在涉及直接面部或颅脑创伤的病例中有所描述。在我们的病例中,一名53岁的街头工作者在胸腹挤压伤后不可逆地失明。所进行的检查对于失明原因尚无定论。我们推测静脉血压大幅升高,伴有毛细血管淤滞,进而导致视神经损伤。脂肪栓塞综合征或后部缺血性视神经病变可能是病因,但对此病例来说不太可能。仍存在疑问的是,为何在其他爆炸伤病例中未见到这种机制。最终,导致此处完全不可逆失明的额外因素仍不清楚。