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潜水时眼眶骨膜下出血。

Orbital subperiosteal hemorrhage while scuba diving.

作者信息

Gómez-Ledesma Isabel, Mencía-Gutíerrez Enrique, Gutiérrez-Díaz Esperanza, Alonso-Santiago María A

机构信息

Department of Ophthalmology, Complutense University, Madrid, Spain.

出版信息

Orbit. 2006 Mar;25(1):19-22. doi: 10.1080/01676830500505715.

Abstract

PURPOSE

To report an uncommon case of unilateral subperiosteal hemorrhage while scuba diving involving the orbit, a condition characterized by proptosis and associated severe ocular motility disturbances with displacement of the eyeball.

MATERIAL AND METHODS

Observational case report.

RESULTS

Unilateral subperiosteal hemorrhage in a 31-year-old woman while scuba diving at a depth of 20 meters. This was documented by clinical and radiographic examination. Computed tomography (CT) scan demonstrated a subperiosteal hemorrhage as a self-limited mass protruding into the left orbit. The process resolved without treatment and without visual or motility sequelae. A CT-scan, nuclear magnetic resonance, and conventional angiography did not show any venous abnormalities in the brain.

CONCLUSION

During scuba diving at a depth of 20 meters, the pressure is three atmospheres, whereas within the diving mask the pressure is one atmosphere if it is not equilibrated; thus, a negative pressure is created within the mask. Small vessels can be broken in the conjunctiva or subperiosteal space by this force. It is important to exclude vascular abnormalities, especially if there is a positive family history.

摘要

目的

报告一例潜水时发生的罕见单侧眶骨膜下出血病例,该病症表现为眼球突出,并伴有严重的眼球运动障碍及眼球移位。

材料与方法

观察性病例报告。

结果

一名31岁女性在20米深潜水时发生单侧眶骨膜下出血。通过临床及影像学检查得以证实。计算机断层扫描(CT)显示骨膜下出血形成一个自限性肿块突入左眼眶。该病情未经治疗自行缓解,未遗留视力或眼球运动方面的后遗症。CT扫描、核磁共振成像及传统血管造影均未显示脑部有任何静脉异常。

结论

在20米深潜水时,水压为三个大气压,而如果潜水面罩内压力未平衡,其压力为一个大气压;因此,面罩内会形成负压。这种力量可导致结膜或骨膜下间隙的小血管破裂。排除血管异常很重要,尤其是在有阳性家族史的情况下。

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