Conforto Adriana B, Martin Maria da Graça M, Ciríaco Jovana G M, Leite Claudia C, Campos Cynthia R, Yamamoto Fabio I, Puglia Paulo, Gattás Gabriel, Scaff Milberto
Department of Neurology, Hospital das Clínicas, São Paulo University, São Paulo, Brazil.
Am J Ophthalmol. 2007 Aug;144(2):322-5. doi: 10.1016/j.ajo.2007.03.030.
To report the "salt and pepper"(SP) eye pain as a herald symptom of pontine ischemia.
Observational case series.
We reviewed clinical and neuroimaging findings of four patients who presented initially with the sensation of SP in the eyes and then developed paramedian pontine infarcts confirmed by neuroimaging.
All of the patients developed other neurologic symptoms or signs, either in association with the sensation of SP in the eyes, from hours to days later. Magnetic resonance imaging (MRI) showed paramedian pontine infarcts in all of the patients and angiography showed basilar artery occlusive disease in three of them.
Impending pontine ischemia is an important differential diagnosis in patients with acute ocular pain. Prompt neurovascular evaluation and treatment may avoid devastating brainstem infarcts that cause death or long-term disability, particularly in patients with basilar artery occlusive disease.
报告“椒盐样”（SP）眼痛作为脑桥缺血的先兆症状。
观察性病例系列。
我们回顾了4例患者的临床和神经影像学检查结果，这些患者最初表现为眼部的SP感觉，随后经神经影像学证实发生了脑桥旁正中梗死。
所有患者在数小时至数天后，均出现了与眼部SP感觉相关的其他神经系统症状或体征。磁共振成像（MRI）显示所有患者均有脑桥旁正中梗死，血管造影显示其中3例有基底动脉闭塞性疾病。
即将发生的脑桥缺血是急性眼痛患者的重要鉴别诊断。及时进行神经血管评估和治疗可避免导致死亡或长期残疾的严重脑干梗死，尤其是对于患有基底动脉闭塞性疾病的患者。
