Watnick R L, Trobe J D
WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor 48105-1994.
Ophthalmology. 1989 Dec;96(12):1793-8. doi: 10.1016/s0161-6420(89)32661-3.
An 11-year-old boy with a juvenile nasopharyngeal angiofibroma developed optic disc pallor in one eye and optic disc edema in the other eye (Foster Kennedy Syndrome [FKS]). The mechanism was believed to be bilateral, asymmetric optic nerve compression. Review of the 36 previously reported cases of FKS revealed that 12 cases (33%) were probably also caused by bilateral optic nerve compression. Only eight (22%) of the cases satisfied Foster Kennedy's original hypothesis for the pathogenesis of his syndrome, namely, direct compression of one optic nerve causing atrophy and increased intracranial pressure causing contralateral papilledema. In 15 (41%) reported cases of FKS, descriptions were inadequate to determine a mechanism, while two (5%) were probably caused by long-standing increased intracranial pressure without direct optic nerve compression. The authors believe that as sophisticated imaging permits earlier diagnosis and more precise localization, most future cases of FKS caused by mass lesions will be found to result from bilateral direct optic nerve compression.
一名患有青少年鼻咽血管纤维瘤的11岁男孩，一只眼睛出现视盘苍白，另一只眼睛出现视盘水肿（福斯特·肯尼迪综合征 [FKS]）。其机制被认为是双侧不对称的视神经受压。对先前报道的36例FKS病例的回顾显示，12例（33%）可能也是由双侧视神经受压引起的。只有8例（22%）病例符合福斯特·肯尼迪对其综合征发病机制的最初假设，即一侧视神经直接受压导致萎缩，颅内压升高导致对侧视乳头水肿。在15例（41%）报道的FKS病例中，描述不足以确定机制，而2例（5%）可能是由长期颅内压升高而无直接视神经受压引起的。作者认为，随着先进的影像学检查能够实现更早的诊断和更精确的定位，未来大多数由占位性病变引起的FKS病例将被发现是由双侧直接视神经受压所致。
