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被忽视的瞳孔光反射传递缺陷的证据可能是蛛网膜下腔出血后三叉神经节变性的继发结果;初步实验研究。

Overlooked evidence for transmission deficit of pupillary light reflex can be secondary to trigeminal nerve ganglion degeneration following subarachnoid hemorrhage; preliminary experimental study.

机构信息

Department of Neurosurgery, Medical Faculty of Ataturk University, Erzurum, Turkey.

Department of Neurosurgery, Medical Faculty of Recep Tayyip Erdogan University, Rize, Turkey.

出版信息

Neurol Res. 2024 Feb;46(2):178-186. doi: 10.1080/01616412.2023.2262243. Epub 2024 Jan 1.

Abstract

OBJECTIVE

Although the effect of oculomotor and cervical sympathetic networks on pupil diameter is well known; the effect of the trigeminal nerve on pupil diameter has not been investigated yet. This subject was investigated.

MATERIALS AND METHODS

Five of 23 rabbits were used as a control group (GI;  = 5); 0.5 ccs saline solution into cisterna magna injected animals used as SHAM (GII;  = 5); autologous blood injected to produce SAH used as the study group (GIII;  = 13) and followed up three weeks. Light-stimulated pupil diameters were measured with an ocular tomography device before, middle, and at the end of the experiment. Considering the sclera area/pupil area ratio index (PRI) as the pupillary reaction area, we used this equation for the pupil's rush to light. Degenerated neuron densities of trigeminal ganglia and pupil diameters compared with the Mann-Whitney U test.

RESULTS

The PRI, degenerated neuron density of trigeminal ganglia (n/mm) were: (2.034 ± 0.301)/(13 ± 3) in GI; (1.678 ± 0.211)/(46 ± 9) in GII; and (0.941 ± 0.136)/(112 ± 21) in GIII. P-values between groups as:  < 0.005 in GI/GII;  < 0.0001 in GII/GIII and  < 0.00001 in GI/GIII.

CONCLUSION

Light stimulates the cornea which is innervated by the trigeminal nerves. This experimental study indicates that the pupil remains mydriatic as the cornea is damaged by trigeminal ischemia following SAH and blocks the light flow.

摘要

目的

尽管动眼神经和颈交感神经网络对瞳孔直径的影响众所周知,但三叉神经对瞳孔直径的影响尚未得到研究。本研究对此进行了调查。

材料和方法

23 只兔子中有 5 只作为对照组(GI;n=5);5 只动物向枕骨大池内注射 0.5 cc 生理盐水作为假手术组(GII;n=5);13 只动物自体血注入以产生蛛网膜下腔出血作为实验组(GIII),并在实验结束时进行了为期 3 周的随访。在实验前、中和结束时,使用眼部断层扫描设备测量光刺激瞳孔直径。考虑到巩膜面积/瞳孔面积比指数(PRI)作为瞳孔对光的反应面积,我们使用这个方程来计算瞳孔对光的反应。使用曼-惠特尼 U 检验比较三叉神经节变性神经元密度和瞳孔直径。

结果

PRI、三叉神经节变性神经元密度(n/mm)分别为:GI 组为(2.034±0.301)/(13±3);GII 组为(1.678±0.211)/(46±9);GIII 组为(0.941±0.136)/(112±21)。组间 P 值分别为:GI/GII 组 <0.005;GII/GIII 组 <0.0001;GI/GIII 组 <0.00001。

结论

光刺激角膜,角膜由三叉神经支配。这项实验研究表明,蛛网膜下腔出血后三叉神经缺血导致角膜损伤,阻断了光的流动,瞳孔仍然处于散大状态。

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