Madan Siddharth, Chaudhuri Zia
Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, New Delhi, India.
Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, Dr. RML Hospital and ABVIMS, New Delhi, India.
Oman J Ophthalmol. 2022 Jun 29;15(2):222-224. doi: 10.4103/ojo.ojo_161_21. eCollection 2022 May-Aug.
This short report demonstrates an uncommon presentation of intracranial bleeding and sixth nerve palsy in a child with systemic hypertension due to long-standing unilateral renal artery stenosis of unknown etiology that resulted in contracture of the affected kidney and compensatory hypertrophy of the contralateral kidney. Structural renal damage and cardiac ventricular hypertrophy suggested the pathology and ensuing hypertension to be long-standing; however, renal function tests were normal at presentation. The importance of routine outpatient evaluation of systemic blood pressure in children, similar to adults, so as to diagnose and treat secondary hypertension and its causes early, before further systemic and neurological complications set in, is emphasized. The primary neuro-ophthalmological clinical presentation of the child with subsequent confluence of major pediatric domains of medicine, surgery, neurology, cardiology, nephrology, interventional radiology, and ophthalmology toward optimum multidisciplinary etiological and symptomatic management of the condition and its sequelae and subsequent rehabilitation is described.
本简短报告展示了一名患有系统性高血压的儿童颅内出血和第六对脑神经麻痹的罕见表现，该患儿因病因不明的长期单侧肾动脉狭窄导致患侧肾脏挛缩和对侧肾脏代偿性肥大。肾脏结构损伤和心室肥厚提示病理改变及随之而来的高血压病程较长；然而，就诊时肾功能检查正常。强调了与成人一样，对儿童进行常规门诊系统血压评估的重要性，以便在进一步出现全身和神经并发症之前尽早诊断和治疗继发性高血压及其病因。描述了该患儿的主要神经眼科临床表现，以及随后儿科学、外科学、神经学、心脏病学、肾脏病学、介入放射学和眼科学等主要儿科领域为实现对该疾病及其后遗症的最佳多学科病因和症状管理及后续康复而进行的融合。
