外傷性眼球離脱—症例報告と頭蓋内合併症の発生機序に関する考察

Traumatic Enucleation of the Eye Ball: Report of a case and considerations concerning the pathogenic mechanism of intracranial complications

I．はじめに

　眼球が眼窩内から外へ抜け出てしまう眼球脱臼や眼球離脱は，顔面外傷^{1,4,8,10,12,16,20）}や精神病患者の自己摘出^{3,6,7,9，）}によって生じることがあるが，その報告は稀である．われわれはけんかで左眼球をくり抜かれたことが予想され，クモ膜下出血，脳血管攣縮，脳梗塞をおこし，右眼の視野視力障害をきたした症例を経験したので，文献調査とともに頭蓋内合併症の発生機序についても考察を加える．

A 48-year-old man had his left eye ball enucleated by fingers of an assailant. The optic nerve, measuring 4cm in length, was attached to the enucleated eye ball, but there was neither a wound in his eyelids nor cerebro-spinal fluid leakage from inside the orbit.

He was confused, but responsive and was able to rec-ognize other persons with his right eye. His right-eye vision deteriorated within 24 hours and was almost totally lost for about one month. Three months after the trauma his vision recovered to 0.1, but his visual field showed severe concentric narrowing.