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[瞳孔不等大和恶心]

[Anisocoria and nausea].

作者信息

Glaser E, Klopfer M, Lohmann C, Lanzl I M

机构信息

Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, München.

出版信息

Ophthalmologe. 2009 May;106(5):443-6. doi: 10.1007/s00347-008-1856-2.

Abstract

We present the case of a 40-year-old female patient with sudden onset of anisocoria and unilateral ptosis of the left eye. With the exception of several previous episodes of nausea and vomiting, mild headache and tiredness, combined with the early death of the patient's mother following aortic rupture, patient history and clinical condition showed no pathological findings. Following indicative findings on duplex sonography, a dissection of the left internal carotid artery from its origin to its distal section was detected on CT angiography of the brain vessels and the diagnosis of Horner syndrome due to internal carotid artery dissection was made. Since this condition is associated with serious embolic complications, prompt treatment following diagnosis is of utmost importance. Our patient was treated conservatively using PTT (partial thromboplastin time)-effective heparinisation. Regular checks including kidney ultrasound, blood pressure measurement, imaging and continuous therapy with acetylsalicylic acid are recommended.

摘要

我们报告了一例40岁女性患者,该患者突然出现瞳孔不等大及左眼上睑下垂。除了既往有几次恶心、呕吐、轻度头痛和疲劳发作外,结合患者母亲因主动脉破裂早亡的情况,患者病史和临床状况未发现病理结果。经双功超声检查有提示性发现后,脑血管CT血管造影显示左侧颈内动脉从起始部至远端段夹层分离,诊断为颈内动脉夹层所致霍纳综合征。由于这种情况与严重的栓塞并发症相关,诊断后及时治疗至关重要。我们的患者采用部分凝血活酶时间(PTT)有效的肝素化进行保守治疗。建议进行包括肾脏超声、血压测量、影像学检查以及阿司匹林持续治疗在内的定期检查。

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本文引用的文献

2
Internal carotid artery dissection: an update.
J Neurol Sci. 1998 Jan 8;153(2):146-58. doi: 10.1016/s0022-510x(97)00287-6.

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