Terao S, Ishikawa S, Aoki H, Izumi M, Takeda A
Fourth Department of Internal Medicine, Aichi Medical University.
Rinsho Shinkeigaku. 1991 Feb;31(2):135-41.
A clinicopathological study was conducted in 19 cases (including 9 autopsied) of midbrain corectopia (oval pupil) occurring in the acute stage of cerebrovascular disorders. This ocular symptom manifested itself in conjunction with severe impairment of consciousness invariably in all instances, unilaterally in 11 and bilaterally in 8 cases, with the shape of the pupil and the direction of its displacement varying from case to case. In 17 cases, this patients died several hours to several days after the appearance of this sign. On autopsy were noted small hemorrhagic lesion of the upper mesencephalic tegmentum in 2 cases and conspicuous cerebral herniation in 7 cases. In this study, it was thought that all cases had diffuse lesions including nuclear, infra- and/or supra-nuclear parts of the midbrain. Clinicopathologically, it was difficult to define the corresponding lesion for corectopia. We suggested that this ocular symptom which appeared transiently was the sign of poor prognosis.
对19例（包括9例尸检病例）脑血管疾病急性期出现的中脑瞳孔异位（椭圆形瞳孔）进行了临床病理研究。这种眼部症状在所有病例中均与意识严重障碍同时出现，单侧出现11例，双侧出现8例，瞳孔形状及其移位方向因病例而异。17例患者在出现该体征后数小时至数天内死亡。尸检发现2例中脑上被盖有小出血性病变，7例有明显脑疝形成。在本研究中，认为所有病例均有包括中脑核、核下和/或核上部分的弥漫性病变。临床病理上，难以确定瞳孔异位对应的病变。我们认为这种短暂出现的眼部症状是预后不良的征象。
