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颈内动脉闭塞致视神经与脑组织同时梗塞并不常见,在612例卒中病人中记录有上述表现者3例。3例均发生视乳头肿胀,说明视神经前部有缺血性改变,不能证明视野缺损与病侧半球梗死有明显联系。本例在颈内动脉阻断后病侧视神经和视束同时发生梗死,此情况以前不曾有记载。 患者为男性,52岁,右利手。突然左眼失明、右眼颞侧盲、言语困难、右侧无力。发病当日入院,同时进行化疗。发病前3周因胸腹部非何杰金氏淋巴瘤行手术治疗。检查视乳头和视网膜外观正常,视敏度和视野不能准确测定。混合性失语。右侧轻偏瘫,上肢重于下肢。右侧针刺觉和轻触觉缺失。头部CT示内囊后肢、丘脑、豆状核、内侧颞叶、枕叶内部为低密度区。螺旋CT血管造影示左颈内动脉锥形狭窄,在颅下2cm
Internal carotid artery occlusion of the optic nerve and brain infarction is not common at the same time, in 612 cases of stroke patients recorded in the above-mentioned performance in 3 cases. 3 cases of papilledema occurred, indicating that the anterior optic nerve with ischemic changes, can not prove that visual field defects and the disease side of the hemisphere infarction was significantly linked. In this case after the internal carotid artery occlusion of the lateral optic nerve and optic tract infarction occurred at the same time, this situation has not been documented. Patient is male, 52 years old, right hand. Suddenly left eye blindness, right eye temporal blindness, speech difficulties, weakness on the right. On the day of admission, at the same time for chemotherapy. 3 weeks before onset due to thoracoabdominal non-Hodgkin’s lymphoma surgery. Check the optic nerve and retinal appearance of normal, visual acuity and visual field can not be accurately measured. Mixed aphasia. Right hemiparesis, upper limbs heavier than the lower limbs. Right needle acupuncture and touch sense missing. Head CT showed the inner hind limb, thalamus, lentiform nucleus, the medial temporal lobe, occipital lobe for the low-density area. Spiral CT angiography showed left internal carotid artery conical stenosis, 2cm below the skull