Department of Neurosurgery, Miyagi Children's Hospital, 4-3-17, Ochiai, Sendai 989-3126, Japan.
Department of Neurosurgery, Miyagi Children's Hospital, 4-3-17, Ochiai, Sendai 989-3126, Japan.
J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106410. doi: 10.1016/j.jstrokecerebrovasdis.2022.106410. Epub 2022 Mar 26.
Neurofibromatosis type 1 (NF-1) is associated with multiple vascular abnormalities, including internal carotid artery (ICA) stenosis/occlusion. Depending on the site of stenosis/occlusion of the ICA, both cerebral circulation and ocular circulation can be impaired. We describe a rare pediatric case of ocular ischemic syndrome (OIS) due to ICA occlusion in NF-1. The patient diagnosed with NF-1 suffered right ICA occlusion at 12 years of age, and developed right dense vitreous hemorrhage due to OIS at 13 years of age. The patient underwent right cerebral revascularization surgery to improve cerebral and ocular ischemia, but the visual acuity of the right eye did not improve. This case suggests that attention should be paid not only to cerebral ischemia but also to ocular ischemia in patients with ICA stenosis/occlusion of NF-1. Surgical interventions such as cerebral revascularization surgery should be considered in the early stages of OIS to protect visual function, and careful follow-up is required.
神经纤维瘤病 1 型（NF-1）与多种血管异常有关，包括颈内动脉（ICA）狭窄/闭塞。根据 ICA 狭窄/闭塞的部位，脑循环和眼循环都可能受损。我们描述了一例 NF-1 导致 ICA 闭塞的罕见儿科眼缺血综合征（OIS）病例。该患者诊断为 NF-1，12 岁时发生右侧 ICA 闭塞，13 岁时因 OIS 发生右眼致密玻璃体出血。患者接受了右侧大脑血运重建手术以改善脑和眼部缺血，但右眼视力未改善。本例提示，NF-1 患者 ICA 狭窄/闭塞不仅要注意脑缺血，还要注意眼缺血。对于 OIS，应在早期考虑进行脑血运重建等手术干预，以保护视力功能，并需要仔细随访。
