針刺治療海綿狀血管畸形術後複視病例

Acupuncture Treatment on Cavernous Malformations Post-Operational Diplopia: Case Study

本案例為一33歲女性患者因兩次劇烈頭痛伴隨癲癇發作於壢新醫院神經內科就診，MRI顯示左側顳部病灶部位出血，左側橋腦海綿狀血管畸形，經評估後2019/6/27在臺北榮總做開顱手術，術後左眼視野正常，右眼視野變小，外側60度以後視物不清，橫線呈曲度，視四方形物體下邊較上邊長，雙眼複視。2019/7/24因間歇性頭痛伴隨右臉麻木感、右手掌麻、右側無力、左眼瞼下垂與頭暈入院評估，診斷左側顳部病灶部位再次出血，患者已有三個月身孕，會診婦產科評估後再次進行手術，術後呈現雙眼複視加劇，至臺北榮總傳統醫學部進行針刺治療。目前複視漸漸改善，視物模糊、左眼瞼下垂、手腳麻木皆獲得良好改善。

This is a case of acupuncture treatment of diplopia after the removal of cavernous malformation surgery. The acupuncture treatment was successful and well received. This case showed a thirty-three-year-old female patient who had severe headache and one onset of epilepsy. She initially received treatment and MRI examination in the department of Neurology, Landseed International Hospital. MRI showed bleeding on the left temporal lesion and cavernous malformation in the left pons. After evaluation, she decided to have craniotomy in Taipei Veteran General Hospital on 2019/06/27. After the surgery, aside from diplopia, the she also experienced dizziness, photophobia, weakened sense of distance and unsteady gait. She was then hospitalized again on 2019/07/24 with intermittent headache accompanied by numbness in the right face, right palm numbness, weakness in the right side, left eyelid ptosis, and dizziness. With the knowledge of pregnancy, the patient underwent her second craniotomy on 2019/08/01. Diplopia exacerbated after the operation. She later sought help in the department of acupuncture in Taipei Veteran General Hospital. The patient came once a week for scalp needle and body needle treatment. During treatment, diplopia, blurred vision, drooping eyelid, weakness and numbness gradually improved.