Diagnosis and surgical management of traumatic cerebrospinal fluid oculorrhea: case report and systematic review of the literature.
Diagnosis and surgical management of traumatic cerebrospinal fluid oculorrhea: case report and systematic review of the literature.
复制标题
外伤性脑脊液性眼漏的诊断和手术治疗：病例报告和文献系统回顾。
DOI：
10.1055/s-0033-1347902
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发表时间：
2013
影响因子：
0.5
通讯作者：
Zada,Gabriel
中科院分区：
文献类型：
--
作者：
Pease,Matthew;Marquez,Yvette;Tuchman,Alex;Markarian,Alex;Zada,Gabriel
背景眼漏，或脑脊液漏发展从颅眶瘘，是一种罕见的发展，以下traumatic injuries.Case Report一个22岁的男子参与了机动车事故开发了爆裂性骨折的左眶顶穿透额叶，诱发眼漏。他接受了眶上开颅手术切除的骨碎片和颅底重建使用percranial flaps.MethodsA系统回顾的数据库进行了识别所有以前的情况下，创伤性oculrivalence.ResultsTwenty-two报告的情况下，符合纳入标准，随后的分析。分别有14名（64%）和8名（36%）患者因钝性和穿透性头部损伤而发生眼漏。最常见的机制是车祸、刺伤、福尔斯和枪伤。眼部症状和体征包括视力丧失、眼肌麻痹和瞳孔功能障碍是常见的相关发现。初步保守治疗是成功的4例患者。13例患者进行了初步的手术干预，和3个额外的患者需要手术干预失败的保守treatment.ConclusionAlthough眼漏很少发展严重的眼眶外伤，怀疑，但应保持，以促进更迅速的诊断和管理。保守治疗与手术治疗的决定通常取决于骨折和硬脑膜损伤的严重程度。
BackgroundOculorrhea, or cerebrospinal fluid leakage developing from a cranio-orbital fistula, is a rare development following traumatic injury.Case ReportA 22-year-old man involved in a motor vehicle accident developed a blowout fracture of the left orbital roof penetrating the frontal lobe, inducing oculorrhea. He underwent a supraorbital craniotomy for removal of the bony fragment and skull base reconstruction using a pericranial flap.MethodsA systematic review of the database was performed to identify all prior cases of traumatic oculorrhea.ResultsTwenty-two reported cases met inclusion criteria for subsequent analysis. Oculorrhea developed due to blunt and penetrating head injury in 14 (64%) and 8 patients (36%), respectively. The most common mechanisms were car accidents, stab wounds, falls, and gunshot wounds. Ocular signs and symptoms—including visual loss, ophthalmoplegia, and pupillary dysfunction—were commonly associated findings. Initial conservative management was successful in four patients. Thirteen patients underwent initial surgical intervention, and three additional patients required operative intervention following failed conservative treatment.ConclusionAlthough oculorrhea rarely develops following severe orbital trauma, suspicion should nevertheless be maintained to facilitate more prompt diagnosis and management. The decision for conservative versus surgical management often depends on the severity of the fracture and dural injury.