頸部症候群，とくに"鞭打ち損傷"に伴う眼症状についての検討

EYE SYMPTOMS IN CASES OF CERVICAL TRAUMA

I．緒言

　頭部あるいは頸部外傷後，頸部症候群の出現したもののなかには，眼がかすむ，眠が疲れる，ぼやける，二重に見える，視力が低書下した，眼の奥が痛む，充血して涙が出るといつたような眼症状のいずれかを訴えるものが多い。これらの比較的頑固な症状は，他の頸部症状が軽快ないし消失するにつれ自覚しなくなるようである。眼のかすみや他の自律神経症状が，頸部交感神経の刺激によつて出現することは，すでにBarre-Lieouにより証明されているが，われわれは臨床的立場から，鞭打ち損傷または頭部外傷後に現われる眼の症状がはたしてどの程度に頸部交感神経と関連があるのかを追究するとともに，個々の眼の症状についても検討を加えてみた。

Blurred vision, retrobulbar pain, conjunctival hy-peremia and epiphora are frequently noted in the patients with cervical syndrome following cranio-cervical trauma, especially after whiplash injuries. Accommodative power, intraocular tension, diameter of pupils, width of palpebral fissure and exophthal-mic grade were examined in the patients with these eye symptoms.

The occurrence of eye symptoms was seen in about 9% of total head and neck injuries and in 22.5% of traumatic cervical syndrome in our clinic. So-called Barre's syndrome, the posterior cervical sympathetic syndrome were noticed in 85% of the cases with the eye symptoms, but in only 32% of those who had no such symptoms. The onset of the eye symptoms has a tendency to be delayed, compared with that of other local cervical syndromes such as neck pain or occipitalgia.

The results of the above-mentioned ophthalmolo-gical examination showed intraocular hypotension, asymmetry of intraocular tension and disturbance of accomoclative power in most cases with eye symp-toms. As far as the above eye symptoms were concerned, stellate ganglion blocks with local anes-thetics were very effective.

It is emphasized that these eye symptoms are induced by the irritation of cervical sympathetic system.