Horton J C, Fishman R A
Department of Ophthalmology, University of California, San Francisco 94143-0730.
Ophthalmology. 1994 Feb;101(2):244-51. doi: 10.1016/s0161-6420(94)31340-6.
Spontaneous intracranial hypotension has been considered a rare clinical entity, with less than 75 cases reported in the medical literature. With the advent of magnetic resonance imaging (MRI), spontaneous intracranial hypotension currently is being recognized more frequently. The authors report the neurovisual manifestations of this disorder in a consecutive series of three patients.
Each patient underwent clinical examination, computerized visual field testing, and MRI. After treatment, each patient was re-examined, and MRI was repeated.
Two patients had transient visual obscurations and unusual binasal visual field defects on automated perimetry. A third patient had diplopia from an abducens nerve paresis. After treatment of spontaneous intracranial hypotension, these findings improved or resolved.
This case series, and a review of previously reported cases, indicates that neurovisual problems are common in patients with spontaneous intracranial hypotension. Findings may include diplopia from sixth nerve paresis, transient visual obscurations, blurred vision, visual field defects, photophobia, and nystagmus.
自发性颅内低压一直被认为是一种罕见的临床病症，医学文献中报道的病例不足75例。随着磁共振成像（MRI）的出现，目前自发性颅内低压的诊断更为常见。作者报告了连续3例该疾病患者的神经视觉表现。
每位患者均接受了临床检查、计算机视野测试和MRI检查。治疗后，对每位患者进行了复查，并重复了MRI检查。
2例患者出现短暂性视力模糊和自动视野检查中异常的双鼻侧视野缺损。第3例患者因展神经麻痹出现复视。自发性颅内低压治疗后，这些症状得到改善或消失。
该病例系列以及对既往报道病例的回顾表明，神经视觉问题在自发性颅内低压患者中很常见。症状可能包括第六神经麻痹引起的复视、短暂性视力模糊、视力减退、视野缺损、畏光和眼球震颤。
