Shuaib A, Israelian G, Lee M A
Foothills Hospital, Calgary, Alberta, Canada.
J Clin Neuroophthalmol. 1989 Mar;9(1):47-9.
An isolated dilated and fixed pupil in the absence of other neurological dysfunction usually suggests ciliary ganglion dysfunction or direct pharmacological blockade of the parasympathetic fibers to the pupil. A unilateral dilated pupil as a manifestation of a mesencephalic hemorrhage has not, to our knowledge, previously been reported. We now describe a 35-year-old woman who had a headache and a dilated and nonreactive right pupil. A cranial computed tomography scan showed a small hemorrhage in the midbrain, and a cerebral angiogram was normal. Mesencephalic hemorrhage should be considered in the differential diagnosis of an isolated dilated pupil.
在没有其他神经功能障碍的情况下，孤立的瞳孔散大固定通常提示睫状神经节功能障碍或瞳孔副交感神经纤维的直接药理学阻断。据我们所知，以前尚未报道过单侧瞳孔散大作为中脑出血的一种表现。我们现在描述一名35岁女性，她有头痛和右侧瞳孔散大且无反应。头颅计算机断层扫描显示中脑有少量出血，脑血管造影正常。在孤立性瞳孔散大的鉴别诊断中应考虑中脑出血。
