Texas A and M University Health Science Center College of Medicine, Scott and White Clinic, Temple, TX 76508, USA.
J Neurointerv Surg. 2009 Jul;1(1):32-4. doi: 10.1136/jnis.2009.000281. Epub 2009 Jul 3.
Ocular gaze deviation (OGD) is a well known clinical observation (Prevost's sign) in patients with acute cerebral ischemic stroke. Although OGD has been observed on CT in acute stroke, no investigation has quantified the degree of OGD in acute stroke.
A blinded prospective comparison was performed of two groups of adult patients who underwent CT of the brain. Group 1 comprised patients with acute hemiplegia or hemiparesis due to middle cerebral artery ischemic stroke. Group 2 included ambulatory outpatients with a history of headache but no clinical neurologic signs or cerebral pathology on CT. The CT images were cropped to only show the orbital contents. A neuroradiologist, who was blinded to the clinical data, then measured the OGD for both groups. The OGD was quantified using the axial planes of the lenses relative to the nasal midline structures, and the bilateral OGD average was calculated. Both groups were also evaluated for conjugate or disconjugate gaze.
were analyzed using Fisher's exact test.
10 of 70 patients in group 1 and 15 of 46 patients in group 2 were eligible for analysis. The frequency of conjugate and disconjugate gaze was similar in the two groups (p = 0.596). An averaged OGD of >14° and an OGD >18° in either globe was predictive of the presence of acute stroke (p = 0.0166).
Measurement of OGD is useful in predicting the presence of acute ischemic stroke.
眼球凝视偏差（OGD）是急性脑缺血性卒中患者的一种众所周知的临床观察（普雷沃斯特征）。尽管在急性中风的 CT 上已经观察到了 OGD，但尚未有研究对急性中风的 OGD 程度进行量化。
对两组接受脑部 CT 的成年患者进行了一项盲法前瞻性比较。第 1 组包括因大脑中动脉缺血性卒中而出现急性偏瘫或偏瘫的患者。第 2 组包括有头痛史但 CT 无临床神经系统体征或脑部病理学改变的门诊患者。将 CT 图像裁剪仅显示眶内容物。一位对临床数据不知情的神经放射科医生对两组患者的 OGD 进行了测量。OGD 使用晶状体的轴向平面相对于鼻中线结构进行量化，并计算双侧 OGD 的平均值。两组患者还进行了共轭或非共轭凝视评估。
使用 Fisher 确切检验进行分析。
第 1 组 70 例患者中有 10 例，第 2 组 46 例患者中有 15 例符合分析条件。两组患者的共轭和非共轭凝视频率相似（p=0.596）。平均 OGD>14°且任何一只眼球的 OGD>18°均可预测急性中风的存在（p=0.0166）。
OGD 的测量有助于预测急性缺血性中风的发生。
