Keltner J L, Albert D M, Lubow M, Fritsch E, Davey L M
Arch Ophthalmol. 1977 Jan;95(1):97-104. doi: 10.1001/archopht.1977.04450010097009.
Decompression of the perioptic meninges for intractable chronic papilledema was done in a patient with a right parietal temporal glioblastoma multiforme. The patient died 39 days postoperatively. Histologic study of the optic nerves indicated fistulas in the dura compatible with cerebrospinal fluid (CSF) egress and maintenance of a normal subarachnoid space around the nerve. Two additional patients with unilateral optic nerve decompression producing bilateral resolution of papilledema were studied. We contend that egress of CSF was the principle mode of action in these three cases. How long the dural fistula remains patent is unknown. Reports in the literature show considerable variation in the effects of optic nerve decompression. Anatomic variation of the intracanalicular subarachnoid space together with differences in underlying pathologic condition, surgical technique, and patient response may explain discrepancies among the results reported.
对一名患有右顶颞叶多形性胶质母细胞瘤的患者进行了视神经周围脑膜减压术以治疗顽固性慢性视乳头水肿。患者术后39天死亡。对视神经的组织学研究表明，硬脑膜存在与脑脊液（CSF）流出相符的瘘管，且神经周围蛛网膜下腔保持正常。另外对两名接受单侧视神经减压术且双侧视乳头水肿消退的患者进行了研究。我们认为脑脊液流出是这三例患者的主要作用方式。硬脑膜瘘管保持开放的时间尚不清楚。文献报道显示视神经减压术的效果差异很大。管内蛛网膜下腔的解剖变异，以及潜在病理状况、手术技术和患者反应的差异，可能解释了所报道结果之间的差异。
