Granger Robert H, Bonnelame Thomas, Daubenton John, Dreyer Michael, McCartney Paul
Department of Platic and Reconstructive Surgery, Royal Hospital Hobart, Tamaria, Australia.
J Pediatr Ophthalmol Strabismus. 2009 Jul-Aug;46(4):238-40. doi: 10.3928/01913913-20090706-13. Epub 2009 Mar 20.
A 14-year-old girl had a 3-month history of headache and blurred vision. Funduscopy showed bilateral optic disc edema. Findings on brain imaging were normal, and a diagnosis of idiopathic intracranial hypertension was confirmed after lumbar puncture showed an elevated opening pressure of 32 cm H(2)O. Optic nerve head drusen were noted on computed tomography scan and confirmed with B-scan ultrasound. After 2 years, resolution of symptoms coincided with variable compliance to treatment with acetazolamide and concomitant papilledema. In general, optic disc edema poses a clinical conundrum due to the more common occurrence of optic nerve head drusen, potentially resulting in delayed diagnosis and treatment of idiopathic intracranial hypertension.
一名14岁女孩有3个月的头痛和视力模糊病史。眼底镜检查显示双侧视盘水肿。脑部影像学检查结果正常,腰椎穿刺显示初压升高至32 cm H₂O后,确诊为特发性颅内高压。计算机断层扫描发现视神经乳头 drusen,并经B超扫描证实。2年后,症状缓解,同时对乙酰唑胺治疗的依从性不一,并伴有视乳头水肿。一般来说,由于视神经乳头drusen更为常见,视盘水肿会带来临床难题,可能导致特发性颅内高压的诊断和治疗延迟。