Zimmerman C F, Van Patten P D, Golnik K C, Kopitnik T A, Anand R
Department of Ophthalmology, University of Texas, Southwestern Medical Center at Dallas 75235-9057, USA.
Ophthalmology. 1995 Apr;102(4):594-8. doi: 10.1016/s0161-6420(95)30979-7.
Global orbital infarction results from ischemia of the intraocular and intraorbital structures due to hypoperfusion of the ophthalmic artery and its branches.
The authors describe six patients in whom acute proptosis, ophthalmoplegia, and blindness developed immediately after surgery for intracranial aneurysms.
All patients underwent standard frontotemporal craniotomies to clip their aneurysms. In all patients, proptosis, ophthalmoplegia, and blindness developed in the immediate postoperative period; fundus abnormalities included retinal edema, retinal arteriolar narrowing and other vascular abnormalities, and pale optic disc swelling. Some patients had facial and corneal anesthesia. Ophthalmoplegia and facial anesthesia improved in most patients, but none regained any vision in the affected eye.
Orbital infarction syndrome is a rare complication of neurosurgical procedures. Increased orbital pressure probably reduced ophthalmic artery and collateral arterial perfusion, resulting in ischemia of the intraocular and intraorbital structures. There may be multiple factors that compound the risk for orbital infarction, and patients with subarachnoid hemorrhage, increased intracranial pressure, anomalous arterial or venous circulation, or impaired orbital venous outflow seem particularly vulnerable.
全球性眶梗死是由于眼动脉及其分支灌注不足导致眼内和眶内结构缺血所致。
作者描述了6例在颅内动脉瘤手术后立即出现急性眼球突出、眼肌麻痹和失明的患者。
所有患者均接受标准额颞开颅术夹闭动脉瘤。所有患者在术后即刻出现眼球突出、眼肌麻痹和失明；眼底异常包括视网膜水肿、视网膜小动脉狭窄及其他血管异常，以及视盘苍白肿胀。部分患者有面部和角膜感觉缺失。大多数患者的眼肌麻痹和面部感觉缺失有所改善，但患眼均未恢复任何视力。
眶梗死综合征是神经外科手术的一种罕见并发症。眶压升高可能会降低眼动脉和侧支动脉灌注，导致眼内和眶内结构缺血。可能有多种因素增加眶梗死的风险，蛛网膜下腔出血、颅内压升高、动静脉循环异常或眶静脉流出受损的患者似乎特别易患。
