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临床推理:一位 62 岁女性出现一过性视力丧失。

Clinical Reasoning: A 62-Year-Old Woman With Transient Vision Loss.

机构信息

From the Department of Neurology (L.M.T.S., J.C.R., L.T., E.M., K.D., A.A., J.M., M.M.B.), Miller School of Medicine, University of Miami; Neurology Services (L.M.T.S., J.C.R., L.T., E.M., K.D., A.A., J.M., M.M.B.), University of Miami Hospital and Clinics and Jackson Memorial Hospital; and Department of Neurology (L.T.), Bruce W Carter VA Medical Center, Miami, FL.

出版信息

Neurology. 2023 Sep 5;101(10):e1097-e1103. doi: 10.1212/WNL.0000000000207447. Epub 2023 Jun 8.

Abstract

Transient visual loss (TVL) is a common complaint in the emergency department, with numerous possible etiologies. Prompt evaluation and management of TVL can potentially prevent progression to permanent visual loss. In this case, a 62-year-old woman presented with acute, painless, unilateral TVL. Two weeks before presentation, the patient reported bitemporal headaches and paresthesia of the distal extremities. A review of systems revealed chronic fatigue, cough, diffuse arthralgias, and decreased appetite for the previous 6 months. This case highlights the diagnostic approach to patients with TVL. Some common and rare causes associated with this clinical manifestation are briefly reviewed.

摘要

一过性视力丧失(TVL)是急诊科常见的主诉,其病因众多。及时评估和处理 TVL 可防止视力永久性丧失。本例为一位 62 岁女性,突发单侧无痛性 TVL。就诊前两周,患者自述有双侧颞部头痛和远端肢体感觉异常。系统回顾显示,过去 6 个月患者一直有慢性疲劳、咳嗽、全身关节痛和食欲减退。本病例强调了 TVL 患者的诊断方法。本文简要回顾了与该临床表现相关的一些常见和罕见病因。

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