Rosenthal Joseph, Colachis Sam
Ohio State University Medical Center, Columbus, OH, USA.
J Spinal Cord Med. 2011;34(5):527-9. doi: 10.1179/2045772311Y.0000000021.
To describe a case of a 44-year-old man with complete C4 tetraplegia who developed transient cortical blindness in the subacute setting following episodes of autonomic dysreflexia.
Transient cortical blindness the day after surgery for appendicitis that had resulted in severe autonomic dysreflexia (AD) requiring aggressive blood pressure management. Imaging showed no evidence of acute stroke, but did show vasospasm in the occipital lobes. Vision improved over the next couple of months.
CONCLUSION/CLINICAL RELEVANCE: This case illustrates a possible profound vasomotor phenomenon (cortical blindness) associated with AD and its symptomatic treatment. Early recognition of AD and treatment of its underlying cause cannot be overemphasized.
描述一名44岁完全性C4四肢瘫痪男性病例,该患者在自主神经反射异常发作后的亚急性期出现短暂性皮质盲。
因阑尾炎手术导致严重自主神经反射异常(AD)并需要积极控制血压,术后第二天出现短暂性皮质盲。影像学检查未发现急性卒中证据,但显示枕叶血管痉挛。视力在接下来的几个月内有所改善。
结论/临床意义:该病例说明了一种可能与AD及其对症治疗相关的严重血管运动现象(皮质盲)。早期识别AD并治疗其潜在病因至关重要。