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眼球外伤性前颅窝疝出:一例报告。

Traumatic prolapse of the globe into the anterior cranial fossa: a case report.

机构信息

Department of Ophthalmology, Chengdu Aier Eye Hospital, Chengdu, China.

Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing, China.

出版信息

BMC Ophthalmol. 2020 Apr 3;20(1):128. doi: 10.1186/s12886-020-01403-2.

Abstract

BACKGROUND

Orbital fracture associated with traumatic intracranial prolapse of the eyeball is rare. In all previously reported cases, vision was severely impaired with no light perception. Herein, we report a case of traumatic prolapse of the globe into the anterior cranial fossa, in which the patient's vision was preserved by early repositioning.

CASE PRESENTATION

The present case report focused on a man hit by a steel pipe, leading to prolapse of the globe of the right eye into the anterior cranial fossa through fractures in the superior orbit roof, accompanied by cerebral contusion. The eyeball was immediately repositioned into the orbital cavity, along which the wound tract was debrided and the skull base was repaired. The patient underwent a follow-up period of 12 months, during which the visual acuity increased to 12/20 without any intracranial infections. However, the patient's ptosis persisted and was associated with complete loss of supraduction.

CONCLUSIONS

In this case, early diagnosis and proper globe repositioning with reconstruction of the orbital roof could allow recovery of vision, as well as prevention of intracranial infection.

摘要

背景

眼眶骨折伴外伤性眼球颅内疝出较为罕见。所有之前报道的病例中,视力严重受损,无光感。本文报告了 1 例因外伤导致眼球疝入前颅窝的病例,通过早期复位,患者的视力得以保留。

病例介绍

本病例报告重点介绍了 1 名男性患者被钢管击中,导致右眼眼球通过眶顶骨折疝入前颅窝,同时伴有脑挫裂伤。眼球立即复位到眼眶内,沿伤口通道清创,并修复颅底。患者接受了 12 个月的随访,在此期间,视力提高到 12/20,没有任何颅内感染。然而,患者仍存在上睑下垂,且完全丧失了上转功能。

结论

在本例中,早期诊断和正确的眼球复位,同时重建眶顶,可恢复视力,并预防颅内感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40d1/7119161/6d4f3eb1afc8/12886_2020_1403_Fig1_HTML.jpg

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