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本文作者指出视乳头水肿的名称仅用在颅内压增高病人的视乳头水肿。较老文献中提到约有75～80%双侧视乳头水肿有颅内肿瘤,现在则认为是60%左右。视乳头水肿经常双侧不对称。水肿明显的一侧常常是病变侧。偶见顶叶,特别是颞叶的肿瘤,反而在病变对侧水肿明显。此乃由于肿瘤的移位和室间孔部份性阻塞造成病变对侧的脑内积水所致。当视神经有萎缩时,该侧可不产生视乳头水肿。严格的单侧性视乳头水肿提示:(1)眼眶病变而无颅内压增高;(2)当颅内压坛高时,无视乳头水肿侧有视神经鞘或静脉窦异常;或(3)一侧视神经萎缩,对侧视乳头水肿构成Foster Kennedy氏综合征,提示额叶或嗅沟的肿瘤,但现在以缺血性神经病为公认的最常见原因(假性Foster Kennedy综合征)。幕下肿瘤引起的视乳头水肿比幕上肿瘤引起的发生率为高,二者分别为70%和50%。临床和实验
The authors pointed out that the name of papilledema is only used for optic disc edema in patients with increased intracranial pressure. Older literature mentions that about 75 to 80% of bilateral optic papilla edema has intracranial tumors, which is now considered to be about 60%. Optic edema is often bilaterally asymmetric. The apparent side of edema is often the lesion side. Occasionally, the parietal lobe, especially the temporal lobe tumor, has an obvious edema on the contralateral side of the lesion. This is due to the displacement of the tumor and the partial obstruction of the interventricular pores resulting in hydrocephalus on the contralateral side of the lesion. When the optic nerve is atrophied, there is no papilledema on this side. Strict unilateral optic disc edema suggests: (1) eyelid lesions without increased intracranial pressure; (2) when the intracranial pressure albedo is high, the optic nerve sheath or sinus abnormalities are ignored in the papillary edema; or (3) Lateral optic atrophy and edema to the side of the eye constitute Foster Kennedy’s syndrome, suggesting frontal or olfactory groove tumors, but is now the most common cause of ischemic neuropathy (pseudo-Foster Kennedy syndrome). The incidence of papilledema caused by tumors under the fovea was higher than that caused by supratentorial tumors, which were 70% and 50%, respectively. Clinical and experimental