ABSTRACT
Background Intracranial vascular malformation causes different neurophthalmological symptoms and signs due to oppressing visual-related tissue and cranial nerves after hemorrhage.However,there is no availably systematic clinical research on this disease up to now.Objective This retrospective cases analysis was to explore the neurophthalmological features of intracranial vascular malformation.Methods The clinical datas were collected from 100 cases with intracranial vascular malformation in Affiliated Third Hospital of Sun Yat-sen University from June,2007 to June,2013.The neurophthalmological clinical features including general condition,initial symptom,concomitant symptoms and image results were retrospectively surveyed.Results Neurophthalmological symptoms and signs were found in 20 patients with intracranial vascular malformation by CT and MRI with the detectability 20％ (20/100).The main neurophthalmological symptoms were visual field defect (50％,10/20) and vision loss (45％,9/20).The neurophthalmological signs were pupil abnormalities (35％,7/20).Other neurophthalmological features included optic nerve atrophy (5 ％,1/20),papilloedema (5 ％,1/20) and oculomotor nerve palsy (5 ％,1/20),etc.The relevant cranial diseases included cerebral arteriovenous malformation in 60％ patients (12/20),cavernous angiomas in 35％ (7/20) and venous malformation with cavernous angiomas (1/20).The lesions of cerebral arteriovenous malformation were located in occipital lobe (4 cases),parietal-occipital area (3 cases),temporal lobe (3 cases) and frontal lobe (1 case),midbrain area (1 case) ; while those of cavernous angiomas were located in parietal lobe (1 case),occipital lobe (1 case),gyrus cingulated area occipital lobe (1 case),carvenous sinus (1 case),temporal lobe (1 case),parietal-temporal area (1 case) and pons area (1 case).Intracranial hemorrhage occurred in 14 patients in subarachnoid space (6 cases) and brain (8 cases).Conclusions The patients with intracranial vascular malformation have different neurophthalmological symptoms and signs.Sufficient attention should be paid to the patients with neurophthalmological symptoms and signs.
ABSTRACT
Se realizó estudio descriptivo de 187 pacientes recibidos en atención terciaria de Neuroftalmología, desde fuera de la capital, por trastornos de la motilidad ocular, entre enero/2010 y diciembre/2011, con el objetivo de caracterizar las interconsultas físicas por trastornos de la motilidad ocular solicitadas a servicios de Neuroftalmología de nivel terciario. Las variables estudiadas describieron particularidades epidemiológicas, origen y finalidad de las remisiones. Se evaluó además la posibilidad de interconsulta digital como opción alternativa en cada uno de los casos y sus beneficios potenciales. El 63,1 por ciento de las remisiones procedieron desde fuera de la región occidental, donde se encuentran enclavados los dos centros de atención terciaria de la especialidad. La distancia global recorrida por remisiones físicas fue de 70 286,9 Km. Del total de remisiones realizadas, 131 (70,1 por ciento) fueron clasificadas tributarias de interconsulta digital, lo que representaba una reducción de 54 823,2 Km en términos de distancia global recorrida. Las 56 remisiones restantes pudieron beneficiarse de interconsulta previa a la remisión física según criterio de experto, fundamentalmente para inicio de tratamiento e indicación de estudios complementarios. La Telemedicina aplicada a los trastornos de la motilidad ocular constituye una realidad necesaria y posible con los recursos humanos y estructurarles actuales con los que cuenta la especialidad en el país(AU)
This paper presents a descriptive study in 187 patients with eye movement disorders, received in Third-level Neurophthalmology Units, from far outside Havana, between January/2010 and December/2011, in order to characterize office consultation related to eye movement disorders in Third-level Neurophthalmology Units. Various subjects connected to epidemiological elements, genesis and purpose of the office evaluation were studied. The possibility and advantages of digital consultation were evaluated in each case. Interconsultation from outside the west region, where are both Third-level Neurophthalmology Units, were 63,1 percent. Total traveled-length owing to office evaluation was 70 286, 9 Km. 131 (70,1 percent) patients were classified as candidate for digital cases, reducing 54 823,2 Km the global traveled-length. For the remaining 56 cases, telemedicine consultation previous to the office one could be helpful according to the expert consensus, mainly to begin treatment or to do complementary tests. Telemedicine for eye movement disorders is in fact necessary. It is also possible oriented to all people and structural tools that have the specialty around the country(AU)