Bień E, Czarnecki W, Taczanowski R
Oddziału Ocznego Szpitala Bródnowskiego w Warszawie.
Klin Oczna. 1996;98(6):455-8.
In this paper we present a case of a 60-year-old patient with labile hypertension, who was admitted to hospital because of unilateral exophthalmus and loss of vision of the left eye. During the hospitalization basic laboratory investigations, USG and NMR of orbits and arteriography of internal carotid arteries were carried out. Body temperature and arterial blood pressure were monitored. Leucocytosis and high values of arterial blood pressure in the early hours of the morning were found. Accessory investigations didn't explain the cause of exophthalmus. Repeated NMR of orbits showed image characteristic for retrobulbar haemorrhage in the left orbit. During the hospitalization hypotensive, anti-inflammatory and oedema-reducing treatment was administered, without surgical intervention. This case demonstrates that modern diagnostic investigations must be preceded by precise history taking concerning the early symptoms of the disease, its course and accompanying systemic diseases. Although spontaneous retrobulbar haemorrhages occur rarely, they must be taken into consideration in differential diagnosis of unilateral exophthalmus, especially in elderly patients with atherosclerosis and hypertension.
在本文中，我们介绍了一例60岁患有不稳定型高血压的患者，该患者因单侧眼球突出和左眼视力丧失入院。住院期间进行了基础实验室检查、眼眶超声检查和核磁共振成像以及颈内动脉血管造影。监测了体温和动脉血压。发现白细胞增多以及清晨时动脉血压值较高。辅助检查未能解释眼球突出的原因。眼眶重复核磁共振成像显示左侧眼眶球后出血的图像特征。住院期间给予了降压、抗炎和减轻水肿的治疗，未进行手术干预。该病例表明，现代诊断检查之前必须进行关于疾病早期症状、病程及伴随全身性疾病的精确病史采集。尽管自发性球后出血很少见，但在单侧眼球突出的鉴别诊断中，尤其是在患有动脉粥样硬化和高血压的老年患者中，必须予以考虑。
