视盘评估在急性颅内压升高时的诊断价值。

The diagnostic value of optic disc evaluation in acute elevated intracranial pressure.

作者信息

Steffen H, Eifert B, Aschoff A, Kolling G H, Völcker H E

机构信息

Department of Ophthalmology, University of Heidelberg, Germany.

出版信息

Ophthalmology. 1996 Aug;103(8):1229-32. doi: 10.1016/s0161-6420(96)30518-6.

DOI:10.1016/s0161-6420(96)30518-6

PMID:8764791

Abstract

PURPOSE

Ophthalmologists often are asked to evaluate the optic disc for evidence of acute increased intracranial pressure (ICP). The authors studied the incidence of papilledema in a population of patients with a documented acute increase in ICP.

METHODS

Included in this study were 37 patients with acute elevated ICP due to a spontaneous hemorrhage or craniocerebral trauma. In all patients, the ICP was monitored continuously. Fundus examination was performed twice daily on at least 7 consecutive days.

RESULTS

According to the level and duration of the ICP, the patients were divided into three groups. Group 1 included 13 patients who had a slightly elevated ICP (range, 20-30 mmHg) on at least 3 consecutive days. In this group, 3 of 13 patients demonstrated venous congestion on the fifth or sixth day. No swelling of the optic disc was seen in this group. Group 2 included seven patients with an elevated ICP, with values ranging from 30 to 70 mmHg lasting for at least 3 consecutive days. In this group, one patient had a blurred disc margin on the sixth day. Group 3 included 17 patients with shortlasting ICP values, ranging from 30 to 60 mmHg for less than 72 hour. Neither papilledema nor abnormalities of fundus vessels were seen in this group.

CONCLUSION

Papilledema in acute elevation of ICP is an uncommon event. Its absence does not preclude the presence of ICP elevation.

摘要

目的

眼科医生经常被要求评估视盘，以寻找急性颅内压（ICP）升高的证据。作者研究了有记录的急性ICP升高患者群体中视乳头水肿的发生率。

方法

本研究纳入了37例因自发性出血或颅脑外伤导致急性ICP升高的患者。所有患者均持续监测ICP。连续至少7天每天进行两次眼底检查。

结果

根据ICP的水平和持续时间，将患者分为三组。第1组包括13例患者，其ICP至少连续3天轻度升高（范围为20 - 30 mmHg）。在该组中，13例患者中有3例在第5天或第6天出现静脉充血。该组未观察到视盘肿胀。第2组包括7例ICP升高的患者，其值在30至70 mmHg之间持续至少3天。在该组中，1例患者在第6天视盘边缘模糊。第3组包括17例ICP值持续时间短的患者，范围为30至60 mmHg，持续时间少于72小时。该组未观察到视乳头水肿或眼底血管异常。