Abstract：
BACKGROUND: A case of retropharyngeal abscess complicated by both artery and nerve injury has rarely been reported.
METHODS: A 36-year-old woman suddenly presented with right eye visual loss, dilated pupil, reduced direct light reflex, ptosis and ocular motility disorder on the side of inflammation progression, and was diagnosed with retropharyngeal abscess due to Fusobacterium necrophorum. The patient was treated only with antibiotics and, no further surgery was necessary but tracheotomy. Four months later, MRA showed right ICA occlusion and left ICA stenosis. MRI revealed continuous spread of inflammation due to the abscess from the retropharyngeal to the intracranial space.
RESULTS: These severe complications would be attributed to an endothelial damage to the arterial wall and an ischemic neuropathy caused by inflammation and thrombogenesis due to Fusobacterium necrophorum.
CONCLUSIONS: This case should provide a better understanding of the mechanism of vascular and cranial nerve injury due to retropharyngeal infections, and highlights the need for early antibiotic therapy and repeated vascular evaluation.
METHODS: A 36-year-old woman suddenly presented with right eye visual loss, dilated pupil, reduced direct light reflex, ptosis and ocular motility disorder on the side of inflammation progression, and was diagnosed with retropharyngeal abscess due to Fusobacterium necrophorum. The patient was treated only with antibiotics and, no further surgery was necessary but tracheotomy. Four months later, MRA showed right ICA occlusion and left ICA stenosis. MRI revealed continuous spread of inflammation due to the abscess from the retropharyngeal to the intracranial space.
RESULTS: These severe complications would be attributed to an endothelial damage to the arterial wall and an ischemic neuropathy caused by inflammation and thrombogenesis due to Fusobacterium necrophorum.
CONCLUSIONS: This case should provide a better understanding of the mechanism of vascular and cranial nerve injury due to retropharyngeal infections, and highlights the need for early antibiotic therapy and repeated vascular evaluation.
摘要：
背景：一例咽后脓肿并发动脉和神经损伤的病例很少报道。
方法：一名36岁女性突然出现右眼视力下降，扩大瞳孔,减少直接的光反射，炎症进展一侧的上睑下垂和眼部运动障碍，并因坏死梭杆菌被诊断为咽后脓肿。病人只接受了抗生素治疗,除了气管切开术,不需要进一步手术.四个月后,MRA显示右侧ICA闭塞，左侧ICA狭窄。MRI显示，由于脓肿从咽后到颅内间隙，炎症持续扩散。
结果：这些严重的并发症可归因于动脉壁的内皮损伤和坏死梭杆菌引起的炎症和血栓形成引起的缺血性神经病变。
结论：该病例应更好地了解咽后感染引起的血管和颅神经损伤的机制，并强调需要早期抗生素治疗和反复血管评估。
方法：一名36岁女性突然出现右眼视力下降，扩大瞳孔,减少直接的光反射，炎症进展一侧的上睑下垂和眼部运动障碍，并因坏死梭杆菌被诊断为咽后脓肿。病人只接受了抗生素治疗,除了气管切开术,不需要进一步手术.四个月后,MRA显示右侧ICA闭塞，左侧ICA狭窄。MRI显示，由于脓肿从咽后到颅内间隙，炎症持续扩散。
结果：这些严重的并发症可归因于动脉壁的内皮损伤和坏死梭杆菌引起的炎症和血栓形成引起的缺血性神经病变。
结论：该病例应更好地了解咽后感染引起的血管和颅神经损伤的机制，并强调需要早期抗生素治疗和反复血管评估。
