Neurology:表现为凝视诱发性黑朦的视神经鞘脑膜瘤

2018-06-27 zyx整理 神经科病例撷英拾粹

47岁女性,表现为缓慢进行性间歇性视力缺失,右侧凝视时出现,伴右眼视敏度下降。查体发现右眼红色饱和度缺损(red desaturation),瞳孔传入障碍,视敏度受损以及视盘肿胀

47岁女性,表现为缓慢进行性间歇性视力缺失,右侧凝视时出现,伴右眼视敏度下降。查体发现右眼红色饱和度缺损(red desaturation),瞳孔传入障碍,视敏度受损以及视盘肿胀(图A)。头部影像学提示视神经鞘脑膜瘤(图B和C)。本次评估前4个月的脑MRI可见类似的视神经强化模式。凝视诱发性黑朦是偏心凝视时出现的短暂性单眼视力缺失。其提示存在眼外肌围成的椎状区域(intraconal)病理改变,推测是由视网膜或视神经循环血管的位置依赖性闭塞引起的。凝视诱发性黑朦最常见的原因是视神经鞘脑膜瘤和海绵状血管瘤。视神经鞘脑膜瘤的治疗选择包括保守观察,放疗和手术切除。


(图:A:右侧眼底成像可见中至重度的视盘肿胀和脉络膜皱褶[箭];B-C:眼眶增强MRI可见右侧视神经鞘周强化[箭];D:眼眶CT可见右侧视神经钙化[箭])

原始出处:

Johnson SAA, Chen JJ, Tobin WO. Teaching NeuroImages: Optic nerve sheath meningioma presenting as gaze-evoked amaurosis.Neurology. 2018 Jun 5;90(23):e2095-e2096.

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    2018-06-30 gj0740
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    2018-09-30 yinhl1978
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    2018-06-28 龙胆草

    学习谢谢分享

    0

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    2018-06-28 phoebeyan520

    学习了.谢谢分享

    0

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    2018-06-28 wzb521zf

    一起学习学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1666967, encodeId=e5be166696ec3, content=<a href='/topic/show?id=5fda90e061e' target=_blank style='color:#2F92EE;'>#视神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90706, encryptionId=5fda90e061e, topicName=视神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14db26078051, createdName=gj0740, createdTime=Sat Jun 30 01:49:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000482, encodeId=4db5200048259, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Sep 30 23:49:00 CST 2018, time=2018-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280833, encodeId=28591280833ce, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri Jun 29 14:49:00 CST 2018, time=2018-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327633, encodeId=bc4032e63303, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jun 28 08:46:54 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327623, encodeId=59d832e623ca, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jun 28 07:52:05 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327602, encodeId=b83e32e60247, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Thu Jun 28 07:02:04 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327587, encodeId=d4f432e587d9, content=谢谢了.学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu Jun 28 06:34:26 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327573, encodeId=acb532e5735c, content=好好好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Thu Jun 28 05:50:47 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327551, encodeId=630c32e55177, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Jun 28 00:22:14 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 txqjm

    谢谢了.学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1666967, encodeId=e5be166696ec3, content=<a href='/topic/show?id=5fda90e061e' target=_blank style='color:#2F92EE;'>#视神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90706, encryptionId=5fda90e061e, topicName=视神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14db26078051, createdName=gj0740, createdTime=Sat Jun 30 01:49:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000482, encodeId=4db5200048259, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Sep 30 23:49:00 CST 2018, time=2018-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280833, encodeId=28591280833ce, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri Jun 29 14:49:00 CST 2018, time=2018-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327633, encodeId=bc4032e63303, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jun 28 08:46:54 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327623, encodeId=59d832e623ca, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jun 28 07:52:05 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327602, encodeId=b83e32e60247, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Thu Jun 28 07:02:04 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327587, encodeId=d4f432e587d9, content=谢谢了.学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu Jun 28 06:34:26 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327573, encodeId=acb532e5735c, content=好好好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Thu Jun 28 05:50:47 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327551, encodeId=630c32e55177, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Jun 28 00:22:14 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 yjs木玉

    好好好好好好好好

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1666967, encodeId=e5be166696ec3, content=<a href='/topic/show?id=5fda90e061e' target=_blank style='color:#2F92EE;'>#视神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90706, encryptionId=5fda90e061e, topicName=视神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14db26078051, createdName=gj0740, createdTime=Sat Jun 30 01:49:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000482, encodeId=4db5200048259, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Sep 30 23:49:00 CST 2018, time=2018-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280833, encodeId=28591280833ce, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri Jun 29 14:49:00 CST 2018, time=2018-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327633, encodeId=bc4032e63303, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jun 28 08:46:54 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327623, encodeId=59d832e623ca, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jun 28 07:52:05 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327602, encodeId=b83e32e60247, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Thu Jun 28 07:02:04 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327587, encodeId=d4f432e587d9, content=谢谢了.学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Thu Jun 28 06:34:26 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327573, encodeId=acb532e5735c, content=好好好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Thu Jun 28 05:50:47 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327551, encodeId=630c32e55177, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Jun 28 00:22:14 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 惠映实验室

    学习了.谢谢分享.

    0