Fernández Susana, Godino Oscar, Martínez-Yélamos Sergio, Mesa Edilia, Arruga Jordi, Ramón José María, Acebes Juan José, Rubio Francisco
From Department of Neurology (SF, SM-Y, FR), Department of Neurosurgery (OG, JA), Department of Ophthalmology (EM, JA), and Department of Preventive Medicine (JMR), University Hospital of Bellvitge, IDIBELL, Barcelona, Spain.
Medicine (Baltimore). 2007 Sep;86(5):278-281. doi: 10.1097/MD.0b013e318156c67f.
The etiology of cavernous sinus syndrome (CSS) remains difficult to determine in spite of the development of neuroimaging techniques. We conducted the current study to identify clinical and imaging features that allow a reliable approach to the etiologic diagnosis of patients with CSS. We studied a consecutive series of 126 patients with CSS, defined as involvement of 2 or more of the third, fourth, fifth (V1, V2), or sixth cranial nerves, or involvement of only 1 of them in combination with a neuroimaging-confirmed lesion in the cavernous sinus. Tumors were the most common cause of CSS (80 patients). All patients with optic nerve involvement had a tumor. No patient with a normal MRI had a tumor. The lack of pain during the course of the disease (odds ratio [OR], 0.58; 95% confidence intervals [CI], 0.06-0.40), V2 involvement (OR, 12.17; 95% CI, 2.98-49.71), and male sex (OR, 3.2; 95% CI, 1.31-8.14) were independently associated with the presence of a tumor. Pain at the onset of disease (OR, 12.09; 95% CI, 3.14-46.50) and third cranial nerve involvement (OR, 4.9; 95% CI, 1.01-24.60) were independently associated with Tolosa-Hunt syndrome.
尽管神经影像学技术不断发展，但海绵窦综合征（CSS）的病因仍难以确定。我们开展了本研究，以确定能够可靠地对CSS患者进行病因诊断的临床和影像学特征。我们连续研究了126例CSS患者，CSS定义为第三、第四、第五（V1、V2）或第六对脑神经中有2条或更多条受累，或仅其中1条受累并伴有海绵窦内神经影像学证实的病变。肿瘤是CSS最常见的病因（80例患者）。所有视神经受累的患者均患有肿瘤。MRI正常的患者均无肿瘤。病程中无疼痛（比值比[OR]，0.58；95%置信区间[CI]，0.06 - 0.40）、V2受累（OR，12.17；95% CI，2.98 - 49.71）和男性（OR，3.2；95% CI，1.31 - 8.14）与肿瘤的存在独立相关。疾病发作时的疼痛（OR，12.09；95% CI，3.14 - 46.50）和第三对脑神经受累（OR，4.9；95% CI，1.01 - 24.60）与托洛萨 - 亨特综合征独立相关。
