Nogaki H, Tamaki N, Shirakuni T, Kudo H, Matsumoto S
No To Shinkei. 1981 Mar;33(3):223-7.
Operative mortality and morbidity for intracerebral aneurysms has recently reduced with microsurgical technique, so more functional prognosis such as visual disturbance due to fundal hemorrhages has been studied. Here vitreous hemorrhage secondary to ruptured cerebral aneurysms (Terson syndrome) was attentioned. Three patients had more over 2 hours of unconsciousness and one patient experienced repeated episodes of subarachnoid hemorrhage within a week. This suggested rapid increased intracranial pressure resulted in vitreous hemorrhage through the venous congestion, which had been reported by Castrén (1963). All patients became blind because of severe vitreous hemorrhage. First case was followed over 7 years with only conservative therapy, but failed to improve. Another 3 cases regained visual acuity soon after operation. We emphasized vitreous hemorrhage as an important functional prognostic factor after ruptured intracerebral aneurysms and effective results of vitrectomy was showed.
随着显微外科技术的发展,脑内动脉瘤的手术死亡率和发病率最近有所降低,因此对更多功能预后情况,如眼底出血导致的视觉障碍进行了研究。在此,继发于破裂脑动脉瘤的玻璃体积血(特森综合征)受到了关注。3例患者昏迷超过2小时,1例患者在一周内反复发生蛛网膜下腔出血。这表明颅内压迅速升高导致玻璃体积血,是通过静脉淤血造成的,这一点卡斯滕(1963年)曾有报道。所有患者均因严重玻璃体积血而失明。第一例仅接受保守治疗随访7年,但未改善。另外3例术后视力很快恢复。我们强调玻璃体积血是脑内动脉瘤破裂后一个重要的功能预后因素,并显示了玻璃体切除术的有效效果。