Puchalska-Niedbał Lidia, Jezewski Dariusz
Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72, 70-111 Szczecin.
Ann Acad Med Stetin. 2007;53 Suppl 1:80-4; discussion 84.
The neurosurgical treatment of arachnoid cyst consist in evacuation of the cyst and in consequence the decrease of the endocranial pressure. From the neurosurgical point of view, both the endocranial hypertension and the sudden hypotension inside a skull after a surgical motion are very dangerous. The sudden loss of vision is the most adverse surgical complication for the patient. The aim of the work is the presentation of the child, who suddenly and completely lost the sight after performing a neurosurgical evacuation of the cyst of the arachnoidea.
We introduce 6-year-old boy, who went blind after executed puncture of the arachnoidea cyst of temporal region of the brain. The dramatic, sudden lack of the feeling of light perception that lasted for about 2 weeks caused confusion and anxiety of the child. The vision slowly began to come back as time goes by, at first light perception recovered in one eye, and only after several months in the second eye too. Ptosis of one of the eyelid subided entirely. We observed the diminution of the squint angle, which appeared after the surgical intervention, as the result of applied treatment too.
The mechanism of the origin of this occurrence has not been fully identified, most likely it comes into being as a result of disturbances in the microcirculation of the optical nerve and the chiasma optical. The boy has been treated three times with Trental during the first year. After eight months from the incident of loss of vision, the acuity vision in right eye was 1/50 and 0.2 in left eye. We applied the intensive treatment of amblyopia and squint according to Szczecin's school of the strabismus treatment. The child obtained the improvement of the eyesight in the right eye to 0.1 and in the left eye to 0.9 (according to Snellen test).
The operative treatment of the arachnoidea cyst is an efficient conduct, though, at times complications happen which make the result of the treatment worse.
蛛网膜囊肿的神经外科治疗包括囊肿排空，从而降低颅内压。从神经外科角度来看，颅内高压以及手术操作后颅骨内的突然低血压都非常危险。突然失明是对患者最不利的手术并发症。本文的目的是介绍一名儿童，其在进行蛛网膜囊肿的神经外科排空术后突然完全失明。
我们介绍一名6岁男孩，其在接受颞叶蛛网膜囊肿穿刺后失明。持续约2周的戏剧性、突然的光感缺失使孩子感到困惑和焦虑。随着时间推移，视力逐渐开始恢复，起初一只眼睛恢复了光感，几个月后另一只眼睛也恢复了。一侧眼睑的上睑下垂完全消退。我们还观察到，由于所采用的治疗，手术干预后出现的斜视角度减小。
这种情况的发生机制尚未完全明确，很可能是由于视神经和视交叉微循环紊乱所致。该男孩在第一年接受了三次曲克芦丁治疗。视力丧失事件发生八个月后，右眼视力为1/50，左眼视力为0.2。我们根据什切青斜视治疗学派的方法对弱视和斜视进行了强化治疗。孩子的视力得到改善，右眼提高到0.1，左眼提高到0.9（根据斯内伦视力表测试）。
蛛网膜囊肿的手术治疗是一种有效的治疗方法，不过有时会出现并发症，使治疗结果变差。
