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颅内肿瘤切除术后眶切开术引起的视振荡

Oscillopsia following orbitotomy for intracranial tumor resection.

作者信息

Goethe Eric A, Hartford Juliet, Foroozan Rod, Patel Akash J

机构信息

Department of Neurosurgery Baylor College of Medicine, Houston, Texas, United States.

Department of Opthalmology, Baylor College of Medicine, Houston, Texas, United States.

出版信息

Surg Neurol Int. 2021 Sep 13;12:459. doi: 10.25259/SNI_498_2021. eCollection 2021.

Abstract

BACKGROUND

Oscillopsia is a visual phenomenon in which an individual perceives that their environment is moving when it is in fact stationary. In this report, we describe two patients with pulsatile oscillopsia following orbitocranial approaches for skull base meningioma resection.

CASE DESCRIPTION

Two patients, both 42-year-old women, underwent orbitocranial approaches for resection of a right sphenoid wing (Patient 1) and left cavernous sinus (Patient 2) meningioma. Patient 1 underwent uncomplicated resection and was discharged home without neurologic or visual complaints; she presented 8 days later with pulsatile oscillopsia. This was managed expectantly, and MRA revealed no evidence of vascular pathology. She has not required intervention as of most recent follow-up. Patient 2 developed trochlear and trigeminal nerve palsies following resection and developed pulsatile oscillopsia 4 months postoperatively. After patching and corrective lens application, the patient's symptoms had improved by 26 months postoperatively.

CONCLUSION

Oscillopsia is a potential complication following skull base tumor resection about which patients should be aware. Patients may improve with conservative management alone, although the literature describes repair of orbital defects for ocular pulsations in traumatic and with some developmental conditions.

摘要

背景

视振荡是一种视觉现象,即个体在其周围环境实际上静止时却感知到环境在移动。在本报告中,我们描述了两名在经眶颅入路切除颅底脑膜瘤后出现搏动性视振荡的患者。

病例描述

两名患者均为42岁女性,分别接受了经眶颅入路切除右侧蝶骨嵴(患者1)和左侧海绵窦(患者2)脑膜瘤的手术。患者1手术顺利,出院时无神经或视觉方面的不适;但8天后她出现了搏动性视振荡。对此采取了观察等待的处理方式,磁共振血管造影(MRA)未发现血管病变的证据。截至最近一次随访,她未需要进行干预。患者2在切除术后出现滑车神经和三叉神经麻痹,并在术后4个月出现搏动性视振荡。经过眼罩和矫正镜片的应用,患者的症状在术后26个月时有所改善。

结论

视振荡是颅底肿瘤切除术后的一种潜在并发症,患者应予以知晓。患者可能仅通过保守治疗即可改善,尽管文献中描述了针对创伤性和某些发育性疾病中眼部搏动的眼眶缺损修复方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58ab/8492429/778517413fb8/SNI-12-459-g001.jpg

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