Liu H C, Wang W, Li Y, Dong H, Sun B W, Xu Y, Zhao J W, Zhang J L, Zhang T M, Kang J
Zhonghua Yi Xue Za Zhi. 2018 Oct 23;98(39):3183-3186. doi: 10.3760/cma.j.issn.0376-2491.2018.39.011.
To discuss the diagnosis and treatment strategy of traumatic optic nerve neuropathy (TON) combined with carotid artery injury. Retrospective analyses were performed 397 cases of TON at Neurosurgery department of Beijing Tongren Hospital, Capital Medical University (CMU), from January 2016 to December 2017.The clinical experience was concluded. 9 cases of Traumatic Pseudo Aneurysm (TPA) and 16 cases of Traumatic Carotid Artery-Cavernous Sinus Fistula (TCCF) were found.7 cases of TPA were treated by covered stent, the other 2 cases were treated by detachable balloons.11 cases of TCCF were treated by detachable balloons, and 5 cases of fistulas were found spontaneously closed by DSA after 1-3 months.There was no disability rate and mortality in this study. TON combined with carotid artery injury was a critical situation, and sometime without obvious symptoms and sign, which was easily miss diagnosed.It should be with more concern in diagnosing and treating in such cases, to avoid disability rate and mortality.
探讨外伤性视神经病变（TON）合并颈动脉损伤的诊断及治疗策略。对2016年1月至2017年12月首都医科大学附属北京同仁医院神经外科收治的397例TON患者进行回顾性分析，总结临床经验。发现9例创伤性假性动脉瘤（TPA）和16例创伤性颈动脉海绵窦瘘（TCCF）。7例TPA采用覆膜支架治疗，另外2例采用可脱性球囊治疗。11例TCCF采用可脱性球囊治疗，5例瘘口在1至3个月后经数字减影血管造影（DSA）检查发现自行闭合。本研究中无致残率和死亡率。TON合并颈动脉损伤情况危急，有时无明显症状和体征，易漏诊。对此类病例诊治应予以更多关注，以避免致残率和死亡率。
