Guymer R H, Cairns J D, O'Day J
St Vincent's Hospital, Fitzroy, Victoria.
Aust N Z J Ophthalmol. 1993 Aug;21(3):181-5.
We present a patient with chronic myeloid leukemia (CML) who had marked bilateral disc swelling as part of his initial presentation. This occurred in the setting of raised intracranial pressure (ICP), with normal cerebrospinal fluid (CSF) composition and cell content, and normal neuroimaging. We discuss the possible mechanisms which could lead to disc swelling in CML and conclude that the raised ICP and subsequent papilloedema in our patient were the result of poor absorption of CSF into the dural venous sinuses. We propose that the very high white cell count (WCC) led to a hyperviscosity state which resulted in poor absorption of CSF and in so doing, created a clinical picture of benign intracranial hypertension (BIH).
我们报告一例慢性髓性白血病（CML）患者，其初始表现包括明显的双侧视盘肿胀。这发生在颅内压（ICP）升高的情况下，脑脊液（CSF）成分和细胞含量正常，神经影像学检查也正常。我们讨论了可能导致CML患者视盘肿胀的机制，并得出结论，我们患者的ICP升高及随后的视乳头水肿是脑脊液吸收进入硬脑膜静脉窦不良的结果。我们认为，极高的白细胞计数（WCC）导致了血液高黏滞状态，进而导致脑脊液吸收不良，从而形成了良性颅内高压（BIH）的临床表现。
