Countee R W, Gnanadev A, Chavis P
Stroke. 1978 Jan-Feb;9(1):42-5. doi: 10.1161/01.str.9.1.42.
Dilated episcleral vessels associated with ipsilateral internal carotid artery occlusions have been previously reported though not widely appreciated. These ocular changes have been presumed to be manifestations of ocular ischemia. The authors have recently encountered this sign in seven patients and in none was there evidence of ocular ischemia. In addition to an ipsilateral internal carotid artery occlusion, arteriograms demonstrated that the major source of blood supply to the homolateral cerebral hemisphere was by retrograde flow through markedly enlarged ophthalmic arteries filled in retrograde fashion from dilated external carotid collateral channels in the orbit. This association of dilated episcleral arteries as a sign of increased orbital blood flow and the major source of collateral blood supply to the homolateral cerebral hemisphere has not been previously reported. We reemphasize the importance of a careful examination of the episcleral vessels in patients suspected of having internal carotid artery occlusions.
尽管此前已有报道称扩张的巩膜上血管与同侧颈内动脉闭塞有关，但并未得到广泛重视。这些眼部变化被认为是眼部缺血的表现。作者最近在7例患者中发现了这一征象，且无一例有眼部缺血的证据。除同侧颈内动脉闭塞外，动脉造影显示，同侧大脑半球的主要血液供应来源是通过逆行血流，经明显扩张的眼动脉，而这些眼动脉是由眼眶内扩张的颈外动脉侧支通道以逆行方式充盈的。扩张的巩膜上动脉作为眼眶血流增加的征象以及同侧大脑半球侧支血液供应的主要来源，这种关联此前尚未见报道。我们再次强调，对于怀疑有颈内动脉闭塞的患者，仔细检查巩膜上血管非常重要。
