Kim Tackeun, Cho Min Jai, Park Sang Jun, Han Moon-Ku, Ojar Davendra Hari, Oh Chang Wan, Bang Jae Seung
Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Acta Neurochir (Wien). 2018 Feb;160(2):301-304. doi: 10.1007/s00701-017-3361-3. Epub 2017 Oct 25.
A 61-year-old woman visited us with recent onset right-side weakness. Magnetic resonance imaging showed ischemic changes at the left internal border zone due to occlusive disease affecting the left proximal internal carotid artery. Prompt oral dual antiplatelet therapy and intravenous fluid were administered with subsequent induced hypertension and without reperfusion therapy. Although the hemiparesis was improved, she complained of a new-onset transient left-side monocular visual loss. Fluorescein angiography confirmed delayed perfusion in the left eye. We performed extracranial-intracranial bypass for flow augmentation. After bypass, the amaurosis fugax resolved. Follow-up retinal fluorescein angiography also showed improved retinal perfusion.
一名61岁女性因近期出现右侧肢体无力前来就诊。磁共振成像显示，由于左侧颈内动脉近端闭塞性疾病，左侧内边界区出现缺血性改变。立即给予口服双联抗血小板治疗和静脉输液，并随后进行诱导性高血压治疗，未进行再灌注治疗。尽管偏瘫有所改善，但她抱怨出现了新的一过性左侧单眼视力丧失。荧光素血管造影证实左眼灌注延迟。我们进行了颅外-颅内旁路手术以增加血流量。旁路手术后，一过性黑矇消失。随访视网膜荧光素血管造影也显示视网膜灌注有所改善。
