Trobe J D, Glaser J S, Post J D
Arch Ophthalmol. 1978 Mar;96(3):457-67. doi: 10.1001/archopht.1978.03910050233009.
A series of 16 patients with unilateral ophthalmoplegia due to mass lesions of the cavernous sinus was analyzed; there were six cavernous meninglomas and nine intracavernous aneurysms. All meningiomas were characterized by painless, insidiously progressive partial nerve palsies, as were half of the aneurysms; the remaining aneurysm patients experienced acute painful episodes. Pharmacologic pupillary tests failed to confirm a coexisting Horner syndrome in the majority of cases with anisocoria. Although plain skull films were unremarkable or misinterpreted as normal, bone tomograms, computerized axial tomograms, radionuclide scans, and cerebral angiograms established the diagnosis in all cases. Because cavernous meningiomas show slow progression and are surgically inaccessible, craniotomy is advised only if the visual pathways or brain stem is compromised. Intractable pain appears to be the only distinct indication for intervention with cavernous aneurysms.
对16例因海绵窦肿块病变导致单侧眼肌麻痹的患者进行了分析；其中有6例海绵窦脑膜瘤和9例海绵窦内动脉瘤。所有脑膜瘤的特征均为无痛性、隐匿性进展的部分神经麻痹，半数动脉瘤患者也是如此；其余动脉瘤患者经历了急性疼痛发作。在大多数瞳孔不等大的病例中，药物性瞳孔试验未能证实并存霍纳综合征。尽管普通颅骨平片无明显异常或被误诊为正常，但骨断层摄影、计算机轴向断层扫描、放射性核素扫描和脑血管造影在所有病例中均确立了诊断。由于海绵窦脑膜瘤进展缓慢且手术难以触及，仅在视觉通路或脑干受到损害时才建议进行开颅手术。顽固性疼痛似乎是干预海绵窦动脉瘤的唯一明确指征。
