Nogaki H, Nakamura M, Tatsumi S
Department of Neurological Surgery, Toyooka Public Hospital, Hyogo, Japan.
No To Shinkei. 1989 Mar;41(3):259-62.
A case of Raeder's syndrome caused by metastatic malignant lymphoma was reported. The patient was 67-year-old male. He had complained of diplopia, ptosis and frontal headache at the left side. Neurological examinations revealed left incomplete Horner's syndrome (miosis and ptosis, but normal facial sweating) and left abducens palsy, which was considered to be Raeder's syndrome Group 1 (Boniuk and Schlazinger's classification). CT scan, MRI and angiography demonstrated a mass lesion in the left cavernous sinus extending to the sphenoparietal sinus, and a mass lesion in the anterior part of the superior sagittal sinus. During his hospitalization, enlargement of the left cervical lymph nodes was noticed. "Malignant lymphoma (non-Hodgkin)" was diagnosed on the basis of biopsy. Group 1 of Raeder's syndrome is rare, but it is important to define the site of lesion, which is located around the paratrigeminal region at the middle cranial fossa. Because these lesions are very small and metastatic in many cases, various neuroradiological investigations, especially MRI, are necessary for early diagnosis and early treatment.
报告了一例由转移性恶性淋巴瘤引起的雷德氏综合征病例。患者为67岁男性。他主诉有复视、上睑下垂和左侧额部头痛。神经学检查发现左侧不完全性霍纳综合征(瞳孔缩小和上睑下垂,但面部出汗正常)以及左侧展神经麻痹,这被认为是雷德氏综合征第1组(博纽克和施拉津格分类法)。CT扫描、MRI和血管造影显示左侧海绵窦有一肿块病变延伸至蝶顶窦,以及上矢状窦前部有一肿块病变。在其住院期间,发现左侧颈部淋巴结肿大。经活检诊断为“恶性淋巴瘤(非霍奇金淋巴瘤)”。雷德氏综合征第1组较为罕见,但明确病变部位很重要,其位于中颅窝三叉神经旁区域周围。由于这些病变在很多情况下非常小且为转移性,各种神经放射学检查,尤其是MRI,对于早期诊断和早期治疗是必要的。