Shkarubo A N, Serova N K, Tropinskaia O F, Shishkina L V, Pronin I N
Zh Vopr Neirokhir Im N N Burdenko. 2005 Apr-Jun(2):20-1; discussion 21-2.
Hemorrhage into the structures of the anterior visual pathway, apoplexy of the chiasma or optic nerves, is a rare pathology that can be caused by different pathological processes among which cavernous angioma and arteriovenous malformation are more frequently mentioned. The cause of chiasmatic apoplexy may be also hemorrhage into the tumor--chiasmatic glioma of blood penetration into the chiasma in pituitary apoplexy. The authors describe a rare case of chiasmatic apoplexy whose cause was chiasmatic cavernoma. In addition to acute visual disorders suggesting the involvement of the left optic nerve, chiasma, and left visual pathway, 23-year-old patient had endocrine disorders as polyuria, polydipsia, which first suggests craniopharyngioma and glioma of the chiasma. A capsule and hematomic clots were removed from the thickened left optic nerve and left chiasmatic half during surgery. Only did a morphological study involving immunohistochemical analysis permit identification of the process as hemorrhage from cavernous micromalformation with the formation of hematoma.
出血进入视觉通路前部结构、视交叉或视神经卒中是一种罕见的病理情况，可由不同的病理过程引起，其中海绵状血管瘤和动静脉畸形被更频繁提及。视交叉卒中的原因也可能是肿瘤内出血，如视交叉胶质瘤，或垂体卒中时血液渗入视交叉。作者描述了一例罕见的视交叉卒中病例，其病因是视交叉海绵状瘤。除了提示左侧视神经、视交叉和左侧视觉通路受累的急性视觉障碍外，这位23岁的患者还有多尿、烦渴等内分泌紊乱症状，这最初提示颅咽管瘤和视交叉胶质瘤。手术中从增粗的左侧视神经和左侧视交叉半侧清除了包膜和血性凝块。只有通过包括免疫组化分析在内的形态学研究才得以确定该病变为海绵状微畸形出血并形成血肿。
