Kolenda H, Schröder M, Mühlendyck H, Rama B, Markakis E
Neurosurgical Department, University of Göttingen, West Germany.
Neurosurg Rev. 1988;11(1):39-43. doi: 10.1007/BF01795693.
Over a period of ten years, 39 patients who had suffered optic nerve compression after a craniocerebral trauma underwent transethmoidal decompression surgery. The operation was performed bilaterally on 5 patients. Fifty percent of patients involved suffered a blunt head or brain injury, the others brain compression or contusion. On the side of optic nerve compression, we found specific signs and symptoms of the compression such as negative or sluggish direct light reaction of the pupil, wounds on the lateral side of the eyebrow, bleeding from the nose, eyelid hematoma, skull fractures and intracranial hematomas. Since radiological and intraoperative findings were the same in only 67% of cases ophthalmological findings such as lack of direct pupil reaction occurring together with preserved consensual light reaction and progressive loss of vision after a traumatic incident are used as guideline for performing transethmoidal decompression of the optic nerve. Surgery produced restitution of visual function in about 10% more cases than conservative therapy reported in the literature.
在十年期间，39例颅脑外伤后出现视神经受压的患者接受了经筛窦减压手术。5例患者进行了双侧手术。受累患者中有50%遭受钝性头部或脑部损伤，其他患者为脑受压或挫伤。在视神经受压侧，我们发现了压迫的特定体征和症状，如瞳孔直接光反应阴性或迟钝、眉外侧伤口、鼻出血、眼睑血肿、颅骨骨折和颅内血肿。由于放射学检查结果与术中所见仅在67%的病例中一致，因此，诸如瞳孔直接反应缺失伴同感性光反应保留以及外伤事件后视力逐渐丧失等眼科检查结果被用作进行视神经经筛窦减压手术的指导。与文献报道的保守治疗相比，手术使视功能恢复的病例多约10%。
