1
|
Kim JS. Posterior Cerebral Artery Disease. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
2
|
Naguib MM, Woodland MB, Foroozan R. Characteristic Visual Field Defect From Lateral Geniculate Body Stroke. J Neuroophthalmol 2021; 41:e756-e758. [PMID: 33870940 DOI: 10.1097/wno.0000000000001226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 58-year-old man presented with a complaint of subjective visual field loss on the right side and hypertensive emergency. Examination revealed a right homonymous hemianopia. Computed tomography imaging revealed an acute stroke of the left lateral geniculate body. A few months later, automated perimetry revealed characteristic visual field changes associated with this lesion. In this report, the anatomy, pathophysiology, clinical findings, and previously reported etiologies of lateral geniculate body lesions are reviewed.
Collapse
Affiliation(s)
- Mina M Naguib
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | | | | |
Collapse
|
3
|
Liang H, Sarma AK, Wang Z, Mo M, Lin J, Ji X, Chen D, Liu Y. Pure Thalamic Infarct: 8-Year Follow-Up Study in a Hospital in China. Front Neurol 2021; 12:715317. [PMID: 34594296 PMCID: PMC8477660 DOI: 10.3389/fneur.2021.715317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Abstract
Pure thalamic infarct is a rare lacunar stroke type, with little known about long-term outcomes. This 8-year, single-center, retrospective study evaluated the clinical background, etiology, Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification, and 8-year follow-up results in 27 patients with pure thalamic infarcts identified by MR diffusion-weighted imaging in Dalian, China. All patients presented chief complaints of limb weakness or sensory disturbances. Hypertension (24/27, 88.9%), diabetes (12/27, 44.4%), atrial fibrillation (1/27, 3.7%), hyperlipidemia (10/27, 37%), hyperhomocysteinemia (6/27, 22.2%), smoking history (10/27, 37%; 9/15, 60% for men; 1/12, 8.3% for women), and excessive alcohol consumption history (7/27, 25.9%; 7/15, 46.7% for men; 0 for women) were observed in our patient population. Based on TOAST classification, 1 patient had large artery atherosclerosis (7.14%), 23 had small vessel occlusion (SVO; 85.2%), and 3 patients were unidentified due to lack of cerebral angiography. The thalamic blood supply classification were as follows: 23 (85.2%), inferolateral territory; 1 (3.7%), tuberothalamic territory; 2 (7.4%), combination of tuberothalamic and paramedian arteries; 1 (3.7%), combination of inferolateral and paramedian arteries; 0, posterior choroidal arteries. During the 8-year follow-up, 3 patients died of colon cancer, multi-organ failure, and kidney failure, respectively; 7 presented with a recurrent stroke; while 10 recovered well with their risk factors under control. In conclusion, our cohort of pure thalamic infarcts were mainly due to SVO (TOAST), with hypertension as the main risk factor, and the inferolateral artery as the most implicated arterial territory. Less severe outcome or stroke recurrence are identified in long-term follow-up of pure thalamic infarcts. Other comorbidities would be cause of death in aged patients.
Collapse
Affiliation(s)
- He Liang
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Anand Karthik Sarma
- Department of Neurology, Wake Forest University, Winston-Salem, NC, United States
| | - Zhenxing Wang
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ming Mo
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianwen Lin
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dong Chen
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yi Liu
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
4
|
Jorge CB, Vanessa CN, Miguel A B, Irene GO, Antonio A. Prognostic Factors for Long-Term Recovery of Homonymous Visual Field Defects After Posterior Circulation Ischemic Stroke. J Stroke Cerebrovasc Dis 2021; 30:105924. [PMID: 34148022 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Ischemic stroke (IS) is the main cause of homonymous visual field defects (HVFDs) in adults. Some reports suggest recovery even in late-phase strokes, but data is sparse. This study examines the frequency of long-term recovery from HVFDs in patients with posterior circulation infarction (POCI) and evaluates whether demographic or clinical characteristics are prognostic factors of perimetric recovery. MATERIALS AND METHODS Our study included patients with HVFDS due to POCI who had undergone 2 or more kinetic perimetric evaluations at least 6 months after the index IS. Clinical and imaging data were systematically reviewed and we performed univariate and multivariate logistic regression analyses to determine whether demographic, stroke etiology (TOAST classification), and initial perimetric patterns were prognostic factors of visual recovery occurring 6 months and beyond from POCI. RESULTS One hundred one patients with POCI were included. Median subject age was 60 years and 54.4% were female. After a median perimetric follow-up time of 13.5 months, spontaneous visual improvement was observed in 15.8% of patients. Prognostic factors for visual improvement were age < 50 years (OR 4.6; P = 0.093), POCI associated with hypercoagulable states (OR 12.3; P = 0.048), and vertebral artery dissection (OR 12.6; P = 0.048), while the presence of complete homonymous hemianopia was a negative predictor of recovery (OR 0.2; P = 0.048). CONCLUSION Partial visual recovery in HVFDs is observed even 6 months and beyond POCI. Age < 50 years and stroke etiology were predictors of recovery.
Collapse
Affiliation(s)
- Cárdenas-Belaunzarán Jorge
- Department of Neuro-Ophthalmology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico; Department of Neuro-Ophthalmology, Asociación para Evitar la Ceguera en México, I.A.P., Mexico City, Mexico
| | - Cano-Nigenda Vanessa
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Barboza Miguel A
- Neurosciences Department, Hospital Dr. Rafael A. Calderón Guardia, CCSS, San José, Costa Rica
| | - González-Olhovich Irene
- Department of Neuro-Ophthalmology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Arauz Antonio
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico.
| |
Collapse
|
5
|
Hemorrhagic Intracranial Cavernoma Presenting as a Homonymous Horizontal Sectoranopia. J Neuroophthalmol 2021; 41:e225-e227. [PMID: 32868569 DOI: 10.1097/wno.0000000000001014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ABSTRACT Hemorrhagic lateral geniculate nucleus (LGN) insults are rare but have been reported in association with tumors, vascular malformations, and trauma. The localization of LGN lesions is facilitated by recognition of pathognomonic visual field defects. A 21-year old woman developed a sudden onset painless left homonymous horizontal sectoranopia. Magnetic resonance imaging revealed a hemorrhagic cavernous malformation of the right temporal lobe. Optical coherence tomography (OCT) and Humphrey perimetry findings localized the lesion to the right LGN. Specifically, OCT testing revealed a right homonymous sectoranopia pattern of hemi-retinal macular ganglion layer-inner plexiform layer (mGCIPL) thinning contralateral to the left sided visual field defect. The OCT pattern reflected retrograde neuroaxonal degeneration from the right LGN lesion. This case highlights a unique pattern of mGCIPL thinning characteristic for a posterior lateral choroidal artery injury, affecting the LGN. These findings illustrate how functional eloquence correlates with topographical elegance in the afferent visual pathway.
Collapse
|
6
|
Hanai K, Hashimoto M, Ishikawa F, Nakamura H. Congenital geniculate quadruple sectoranopia with occipital heterotopia. Am J Ophthalmol Case Rep 2020; 20:100929. [PMID: 33005817 PMCID: PMC7509790 DOI: 10.1016/j.ajoc.2020.100929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To report a case of congenital geniculate quadruple sectoranopia associated with occipital heterotopia. Observations A 51-year-old healthy woman was incidentally found to have a left incongruous quadruple sectoranopia. Analysis of the macular ganglion cell complex (GCC) revealed homonymous hemianopic thinning of the inner layer of the retina. Brain magnetic resonance imaging (MRI) showed congenital occipital heterotopia, characterized by hypertrophy of the right parahippocampal gyrus, lingual gyrus, and isthmus of the cingulate gyrus, with shrinkage of the white matter. In addition, serial coronal images on a short tau inversion recovery (STIR) sequence demonstrated an atrophic right optic tract. Conclusion and importance Congenital geniculate quadruple sectoranopia is extremely rare and may be caused by congenital occipital heterotopia.
Collapse
Affiliation(s)
- Kaori Hanai
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
- Corresponding author.
| | - Masato Hashimoto
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
| | - Futoshi Ishikawa
- Fushiminishisen Ishikawa Eye Clinic, S-20, W-14, Chuo-ku, Sapporo, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
| |
Collapse
|
7
|
Lee JI, Boerker L, Gemerzki L, Harmel J, Guthoff R, Aktas O, Gliem M, Jander S, Hartung HP, Albrecht P. Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series. Front Neurol 2020; 11:508. [PMID: 32582017 PMCID: PMC7290045 DOI: 10.3389/fneur.2020.00508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/07/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Visual field defects are a common and disabling consequence of stroke and a negative prognostic factor of patient's quality of life. They result from lesions in different parts of the visual system, most commonly the visual cortex and optic radiation. An important pathophysiological mechanism is transsynaptic retrograde degeneration (TRD). Methods: In a case series 21 patients with posterior cerebral artery (PCA) territory infarctions were analyzed by spectral-domain optical coherence tomography (SD-OCT) and multifocal visual evoked potentials (mfVEPs) cross-sectionally and longitudinally for up to 6 months. In OCT, symptomatic affected nasal and temporal sectors and corresponding visual fields in mfVEPs were compared to the contralateral side. Results: SD-OCT revealed a significant reduction (−2.92 ±2.53 μm, mean ± SD) of the symptomatic nasal macular retinal nerve fiber layer (RNFL) thickness and of the symptomatic temporal peripapillary RNFL after 6 months compared to baseline whereas the symptomatic temporal macular quadrant already showed a significantly thinner RNFL at baseline. The mfVEP first peak latency at baseline was significantly different (nasal visual field +11.69 ±11.17 ms, mean ± SD; temporal visual field +16.63 ±7.97 ms, mean ± SD) on the symptomatic compared to the asymptomatic field. The nasal visual fields partly recovered in amplitude and first peak latency of mfVEPs over the following 6 months compared to baseline. Conclusion: The dynamics of OCT and mfVEP outcomes for degeneration and recovery after PCA infarction differ between the nasal and temporal retinal sector. We postulate that retinal sectors may differ in their temporal pattern of TRD over time after retrogeniculate cerebral infarction.
Collapse
Affiliation(s)
- John-Ih Lee
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Laura Boerker
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Lena Gemerzki
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Jens Harmel
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Rainer Guthoff
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Michael Gliem
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Sebastian Jander
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| |
Collapse
|
8
|
de Vries-Knoppert WA, Baaijen JC, Petzold A. Patterns of retrograde axonal degeneration in the visual system. Brain 2020; 142:2775-2786. [PMID: 31363733 DOI: 10.1093/brain/awz221] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 05/06/2019] [Accepted: 05/28/2019] [Indexed: 12/13/2022] Open
Abstract
Conclusive evidence for existence of acquired retrograde axonal degeneration that is truly trans-synaptic (RTD) has not yet been provided for the human visual system. Convincing data rely on experimental data of lesions to the posterior visual pathways. This study aimed to overcome the limitations of previous human studies, namely pathology to the anterior visual pathways and neurodegenerative co-morbidity. In this prospective, longitudinal cohort retinal optical coherence tomography scans were acquired before and after elective partial temporal lobe resection in 25 patients for intractable epilepsy. Newly developed region of interest-specific, retinotopic areas substantially improved on conventional reported early treatment diabetic retinopathy study (ETDRS) grid-based optical coherence tomography data. Significant inner retinal layer atrophy separated patients with normal visual fields from those who developed a visual field defect. Acquired RTD affected the retinal nerve fibre layer, ganglion cell and inner plexiform layer and stopped at the level of the inner nuclear layer. There were significant correlations between the resected brain tissue volume and the ganglion cell layer region of interest (R = -0.78, P < 0.0001) and ganglion cell inner plexiform layer region of interest (R = -0.65, P = 0.0007). In one patient, damage to the anterior visual pathway resulted in occurrence of microcystic macular oedema as recognized from experimental data. In the remaining 24 patients with true RTD, atrophy rates in the first 3 months were strongly correlated with time from surgery for the ganglion cell layer region of interest (R = -0.74, P < 0.0001) and the ganglion cell inner plexiform layer region of interest (R = -0.51, P < 0.0001). The different time course of atrophy rates observed relate to brain tissue volume resection and suggest that three distinct patterns of retrograde axonal degeneration exist: (i) direct retrograde axonal degeneration; (ii) rapid and self-terminating RTD; and (iii) prolonged RTD representing a 'penumbra', which slowly succumbs to molecularly governed spatial cellular stoichiometric relationships. We speculate that the latter could be a promising target for neuroprotection.
Collapse
Affiliation(s)
- Willemien A de Vries-Knoppert
- Dutch Expertise Centre for Neuro-ophthalmology and Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Johannes C Baaijen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurosurgery, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Axel Petzold
- Dutch Expertise Centre for Neuro-ophthalmology and Department of Neurology, Amsterdam UMC, Amsterdam, The Netherlands.,Moorfields Eye Hospital and The National Hospital for Neurology and Neurosurgery, London, UK.,UCL Queen Square Institute of Neurology, London, UK
| |
Collapse
|
9
|
Vertical Meridian Sparing Homonymous Hemianopia due to an Occipital Infarct. J Neuroophthalmol 2020; 40:e5-e6. [DOI: 10.1097/wno.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Abstract
PURPOSE OF REVIEW This article reviews the anatomy, symptoms, examination findings, and causes of diseases affecting the optic chiasm, optic tracts, optic radiations, and occipital lobes. RECENT FINDINGS Modern ophthalmic imaging can be used to monitor the effects of diseases of the optic chiasm and tract on the retinal ganglion cells. It can also be used to visualize transsynaptic degeneration of the anterior visual pathway in the setting of acquired retrogeniculate lesions. Visual prostheses that directly stimulate the occipital lobe are a potential strategy for rehabilitation that is in active clinical trials. SUMMARY Detecting and characterizing visual deficits due to optic chiasm and retrochiasmal disease are important for the diagnosis, localization, and monitoring of neurologic disease; identifying patient disability; and guiding rehabilitation.
Collapse
|
11
|
Liu A, Sanguino L. Right lateral geniculate nucleus infarct presenting as a left monocular temporal hemianopia. Clin Case Rep 2019; 7:1226-1229. [PMID: 31183099 PMCID: PMC6552942 DOI: 10.1002/ccr3.2189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/10/2019] [Accepted: 04/23/2019] [Indexed: 11/10/2022] Open
Abstract
A lesion to the right lateral geniculate nucleus should cause a complete left monocular hemianopia. We present a case of a patient with left eye monocular temporal hemianopia with two MRIs demonstrating an ischemic defect at the right lateral geniculate body as the likely culprit. Patient improved after 4 days.
Collapse
Affiliation(s)
- Antonio Liu
- Department of NeurologyCalifornia Hospital Medical CenterLos AngelesCalifornia
| | - Luis Sanguino
- Graduate Medical EducationCalifornia Hospital Medical CenterLos AngelesCalifornia
| |
Collapse
|
12
|
Tuttle C, Boto J, Martin S, Barnaure I, Korchi AM, Scheffler M, Vargas MI. Neuroimaging of acute and chronic unilateral and bilateral thalamic lesions. Insights Imaging 2019; 10:24. [PMID: 30796553 PMCID: PMC6386756 DOI: 10.1186/s13244-019-0700-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
The thalami are bilateral ovoid grey matter cerebral structures bordering the third ventricle on both sides, which participate in functions such as relaying of sensory and motor signals, regulation of consciousness, and alertness. Pathologies affecting the thalami can be of neoplastic, infectious, vascular, toxic, metabolic, or congenital origin.The purpose of this review is to provide a comprehensive approach to the thalamus focusing on its anatomy, the main pathologies affecting this structure and their radiological semiology on CT and MRI. We will also illustrate the importance of multimodal MR imaging (morphologic sequences, diffusion-weighted imaging, perfusion, spectroscopy) for the diagnosis and treatment of these conditions.
Collapse
Affiliation(s)
- C Tuttle
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - J Boto
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - S Martin
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - I Barnaure
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - A M Korchi
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - M Scheffler
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - M I Vargas
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
| |
Collapse
|
13
|
Tanaka K, Wada I, Suenaga T. Incongruous, incomplete, homonymous hemianopia due to an infarction localized to the lateral geniculate body. Rinsho Shinkeigaku 2017; 57:595-598. [PMID: 28954971 DOI: 10.5692/clinicalneurol.cn-001055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 45-year-old male was admitted with an acute-onset visual field defect. Goldmann perimetry revealed an incongruent, incomplete right homonymous hemianopia. The left eye showed a wedge-shaped, horizontal right hemianopia, whereas the right eye showed constriction of the right visual hemifield. MRI showed acute infarction localized to the left lateral geniculate body (LGB). LGB has a dual blood supply: from the anterior choroidal artery and from the lateral posterior choroidal artery (LPChA). The LPChA territory of LGB receives projection from the retinal area around the macula and horizontal meridian. Therefore, an LPChA territory infarction of LGB can cause a wedge-shaped, horizontal visual field defect. The visual field defect in our patient would be caused by an LPChA territory infarction of LGB. Our patient showed an incongruent homonymous hemianopia. LGB has six laminae, with the ipsilateral retinal fibers terminating in layers two, three, and five and the crossed fibers terminating in layers one, four, and six. The laminar structure provides the anatomical basis for the incongruous visual field defects in a case of partial lesion of LGB. Based on the present data, we believe that an ischemic lesion localized to LGB should be considered in patients presenting with incongruous, incomplete homonymous hemianopia.
Collapse
Affiliation(s)
- Kanta Tanaka
- Department of Neurology, Tenri Hospital.,Stroke Center, Tenri Hospital
| | - Ikko Wada
- Department of Neurology, Tenri Hospital
| | | |
Collapse
|
14
|
Sizdahkhani S, Magill ST, McDermott MW. Intraventricular Meningioma Resection with Postoperative Ischemia of the Lateral Geniculate Nucleus. World Neurosurg 2017; 106:878-883. [DOI: 10.1016/j.wneu.2017.07.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 11/27/2022]
|
15
|
Kim JS. Posterior Cerebral Artery Disease. Stroke 2016. [DOI: 10.1016/b978-0-323-29544-4.00025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Functional representation of vision within the mind: A visual consciousness model based in 3D default space. JOURNAL OF MEDICAL HYPOTHESES AND IDEAS 2015. [DOI: 10.1016/j.jmhi.2015.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
Abstract
Visual failure of any kind is a common clinical presentation and indication for neuroimaging. Monocular deficits should concentrate the search to the anterior (prechiasmatic) visual pathway. Bitemporal hemianopia suggests a chiasmatic cause, whereas retrochiasmatic lesions characteristically cause homonymous hemianopic defects. Quadrantanopias usually arise from lesions in the optic radiations. Disorders of visual perception can be broadly divided into "where" and "what" problems caused by lesions in the parietal and temporal lobes, respectively, and their associated white matter tracts. Visualization of the retrochiasmatic visual and visual association pathways is aided by diffusion tensor imaging.
Collapse
Affiliation(s)
| | - Adam G Thomas
- Imaging Department, Leicester Royal Infirmary, Leicester, UK; Department of Neuroradiology, Queens Medical Centre, Nottingham, UK.
| |
Collapse
|
18
|
Affiliation(s)
- Hiromasa Tsuda
- Department of Neurology, Tokyo Metropolitan Health and Medical Corporation Toshima Hospital, Japan
| | | |
Collapse
|
19
|
de Vries T, Aries M, De Groot J, Bonte G, de Jong B. A grid-like hemi-field defect following a lacunar infarct in the lateral geniculate nucleus. Clin Neurol Neurosurg 2012; 114:278-80. [DOI: 10.1016/j.clineuro.2011.10.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 10/04/2011] [Accepted: 10/17/2011] [Indexed: 10/15/2022]
|
20
|
|
21
|
Mohr J, Binder JR. Posterior Cerebral Artery Disease. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
22
|
Bilateral sectoranopia caused by bilateral geniculate body infarction in a 14-year-old boy with inflammatory bowel disease. J AAPOS 2010; 14:435-7. [PMID: 21035072 DOI: 10.1016/j.jaapos.2010.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Revised: 05/22/2010] [Accepted: 06/08/2010] [Indexed: 11/22/2022]
Abstract
Bilateral lesions of the lateral geniculate bodies are rare and produce unusual field defects that can be predicted on the basis of their vascular anatomy. We report a rare case of bilateral sectoranopic visual field defects caused by bilateral infarction of the lateral geniculate nucleus in a 14-year-old boy with inflammatory bowel disease and recurrent pancreatitis.
Collapse
|
23
|
Liu GT, Volpe NJ, Galetta SL. Retrochiasmal disorders. Neuroophthalmology 2010. [DOI: 10.1016/b978-1-4160-2311-1.00008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
24
|
Shibata K, Nishimura Y, Kondo H, Otuka K, Iwata M. Isolated homonymous hemianopsia due to lateral posterior choroidal artery region infarction: A case report. Clin Neurol Neurosurg 2009; 111:713-6. [DOI: 10.1016/j.clineuro.2009.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 06/30/2009] [Accepted: 07/04/2009] [Indexed: 10/20/2022]
|
25
|
Tsuda H, Ishikawa H, Koshinaga M, Tamura M, Mizutani T. CASE REPORT Homonymous Hemianopia Due to Cerebral Infarction of the Lateral Geniculate Body. Neuroophthalmology 2009. [DOI: 10.1080/01658100490894834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
26
|
Huang M, Ilsen PF. Sectoranopia: a stroke in the lateral geniculate nucleus or optic radiations? ACTA ACUST UNITED AC 2007; 78:356-64. [PMID: 17601574 DOI: 10.1016/j.optm.2006.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 10/07/2006] [Accepted: 11/22/2006] [Indexed: 11/23/2022]
Abstract
BACKGROUND The lateral geniculate nucleus (LGN) is the site at which ganglion cell axons of the optic tract synapse with neurons that form the optic radiations. Lesions of the perigeniculate visual pathway are characterized by distinct pupillary, visual field, and ophthalmoscopic findings. Such findings, combined with results from neuroimaging, enable one to precisely locate the area of the visual pathway that is involved. CASE REPORT A patient who presented to our clinic with a complaint of narrowly missing several motor vehicle accidents recently was found to have a left horizontal sectoranopia on a screening visual field. Magnetic resonance imaging confirmed the presence of an old infarct involving the optic radiations. The patient's medical history was significant for high homocysteine levels that likely contributed to his having had several cerebral vascular accidents in the past, one of which affected the optic radiations. CONCLUSIONS Damage to the LGN and optic radiations can produce sectoranopic visual field defects. Although it may not be possible to specify the exact location of a lesion, understanding the blood supply of the visual pathway and retinotopic organization of the LGN aids in the localization of infarcts that cause characteristic visual field defects.
Collapse
Affiliation(s)
- Minna Huang
- San Diego VA Healthcare Center, San Diego, California 92161, USA.
| | | |
Collapse
|
27
|
Baker CF, Jeerakathil T, Lewis JR, Climenhaga HW, Bhargava R. Isolated bilateral lateral geniculate infarction producing bow-tie visual field defects. Can J Ophthalmol 2006; 41:609-13. [PMID: 17016535 DOI: 10.1016/s0008-4182(06)80033-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
CASE REPORT We examined a unique case of stroke in a 29-year-old woman. Magnetic resonance imaging revealed isolated bilateral acute infarctions of the lateral geniculate bodies (LGB). Visual field testing demonstrated incongruous but homonymous bilateral visual field loss in a bow-tie configuration. COMMENTS Isolated bilateral damage to the LGB is a rare event. Literature review has revealed only 4 previous incidents of bilateral damage to both LGB. We present a literature review and a case of bilateral LGB infarction producing visual field defects suggestive of bilateral lateral choroidal artery involvement in an individual with classic migraine.
Collapse
Affiliation(s)
- Chad F Baker
- Department of Ophthalmology, University of Alberta, Royal Alexandra Hospital, Edmonton, Canada. cfbaker.ualberta.ca
| | | | | | | | | |
Collapse
|
28
|
Chen HH, Chen CY, Hong CT. Inconspicuous visual field defect in anterior choroidal artery territory infarction. J Clin Neurosci 2006; 13:699-702. [PMID: 16697644 DOI: 10.1016/j.jocn.2005.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 07/12/2005] [Indexed: 11/17/2022]
Abstract
We describe a patient with a right anterior choroidal artery territory infarction and an inconspicuous left visual defect. The anterior choroidal artery is a unique artery of the cerebral circulation. The occlusion of this artery can result in dysfunction of motor, sensory, and visual systems with only rare involvement of higher cortical function. Among symptoms reported, visual abnormalities are the most variable and the least common. However, the visual field abnormality may be overlooked and the incidence underestimated since some patients may not be aware of the problem until uncovered by formal visual field testing.
Collapse
Affiliation(s)
- Hsin-Hung Chen
- Department of Neurology, Taipei Medical University, Municipal Wan Fang Hospital, No. 111, Hsing-Long Road, Section 3, Taipei 116, Taiwan
| | | | | |
Collapse
|
29
|
Denion E, Defoort-Dhellemmes S, Arndt CF, Hache JC. [Quadruple sectoranopia]. J Fr Ophtalmol 2006; 28:1137-44. [PMID: 16395210 DOI: 10.1016/s0181-5512(05)81153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Quadruple sectoranopia is a rare campimetric syndrome involving upper and lower, homonymous, congruent field blind sectors sparing a horizontal zone. Ischemia or infarction of the lateral parts of the lateral geniculate body, supplied by the distal part of the anterior choroidal artery, accounts for the visual field defect. Ganglionic nerve fiber atrophy matched to the visual field defect may be found if the lateral geniculate body dysfunction involves infarction. The four cases reported so far involve the following etiologies: a case of surgical ligation of the distal part of the anterior choroidal artery during cerebral meningioma removal, two cases of stroke with anterior choroidal artery infarction, and a case of vascular steal with anterior choroidal artery blood flow being shunted away from the lateral geniculate body by an arteriovenous malformation. If lateral geniculate body infarction is not solely involved, partial recovery may occur, ischemic quiescent neuronal areas being able to resume their activity following ischemia resolution.
Collapse
Affiliation(s)
- E Denion
- Centre d'Exploration Fonctionnelle de la Vision, Hôpital Roger Salengro, Lille.
| | | | | | | |
Collapse
|
30
|
Lefèbvre PR, Cordonnier M, Balériaux D, Chamart D. An unusual cause of visual loss: involvement of bilateral lateral geniculate bodies. AJNR Am J Neuroradiol 2004; 25:1544-8. [PMID: 15502135 PMCID: PMC7976391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We report the clinical and radiologic features of a 31-year-old woman who suffered incongruous binasal and bitemporal visual field defects and severe sudden visual loss due to hypoperfusion of bilateral lateral geniculate bodies following anaphylactic shock induced by 500 mg amoxicillin per os. Complete neuroophthalmologic examinations were performed regularly for visual acuity, color vision, pupillary reflexes, and visual fields. Additional testing was performed by means of MR imaging of the brain and CSF analysis. Follow-up was performed for 12 months. Vision loss was acute and severe, its onset bilateral and simultaneous. The patient recovered visual acuity of 1.0 within 7 weeks. Color vision was abnormal in both eyes but gradually improved to normal. Visual fields were characterized by incongruous binasal and bitemporal defects, but they reduced progressively. Cerebral MR imaging confirmed the presence of symmetrical lesions confined exclusively within both lateral geniculate bodies. These lesions were best seen on T1-weighted and fluid-attenuated inversion recovery images as high-signal-intensity areas suggestive of hemorrhagic ischemia. CSF analysis was normal and aseptic. Blood tests and cultures excluded any microbial infection. We conclude that shock may induce a bilateral isolated ischemia of the lateral geniculate bodies, resulting in incongruous binasal and bitemporal visual field defects and severe visual loss. MR imaging is the optimal imaging technique to confirm the diagnosis and for follow-up.
Collapse
Affiliation(s)
- Pierre R Lefèbvre
- Department of Ophthalmology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | |
Collapse
|
31
|
Denion E, Defoort-Dhellemmes S, Arndt CF, Gauvrit JY, Blond S, Hache JC. Partially reversible quadruple sectoranopia caused by vascular steal due to an arteriovenous malformation. Graefes Arch Clin Exp Ophthalmol 2004; 243:63-7. [PMID: 15221308 DOI: 10.1007/s00417-004-0937-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Revised: 02/12/2004] [Accepted: 04/06/2004] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lateral, homonymous upper and lower field blind sectors sparing a horizontal zone define quadruple sectoranopia. This rare campimetric deficit involves ischemia or infarction of parts of the lateral geniculate body supplied by the distal anterior choroidal artery. METHODS A 41-year-old patient presented with a complaint of blurred vision. Visual acuity was 20/20 on both sides. Visual field showed a left quadruple sectoranopia. CT scan, MRI, MRA and conventional angiography showed a right cerebral arteriovenous malformation supplied partly by the right anterior choroidal artery. Partial retinal nerve fiber layer atrophy matched to the campimetric deficit proved that some degree of infarction involved the lateral geniculate body. RESULTS The arteriovenous malformation was treated with stereotactic radiosurgery. Two years after treatment, the nidus had completely disappeared. The campimetric deficit began improving from 19 months onwards after stereotactic radiosurgery. Twenty-eight months after treatment, the superior defect had completely reversed. CONCLUSIONS Quadruple sectoranopia involves ischemia or infarction of parts of the lateral geniculate body supplied by the distal anterior choroidal artery. Following radio-induced angioma thrombosis, blood was no longer shunted away from the right lateral geniculate body, whose viable areas resumed their activity. Accordingly, a partial campimetric recovery occurred.
Collapse
Affiliation(s)
- Eric Denion
- Vision Functional Exploration Department, Lille University Hospital, Lille, France.
| | | | | | | | | | | |
Collapse
|
32
|
Saeki N, Fujimoto N, Kubota M, Yamaura A. MR demonstration of partial lesions of the lateral geniculate body and its functional intra-nuclear topography. Clin Neurol Neurosurg 2004; 106:28-32. [PMID: 14643913 DOI: 10.1016/j.clineuro.2003.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Two rare cases with a partial lesion of the lateral geniculate body (LGB) presumably due to ischemia are demonstrated on high resolution MR imaging. A 62-year-old woman (case 1) presented with left homonymous superior quadrantanopia on Goldmann perimetry. Heavily T2 weighted MR images showed a localized lesion at the lateral portion of the LGB. The visual field defect was macular and horizontal meridian sparing and persisted for 9 years. A 49-year-old woman (case 2) presented with a sudden onset of left homonymous horizontal sectoranopia on Humphrey automated perimetry and heavily T2 weighted images demonstrated a lesion localized at the more medial part of the right LGB. Axons originating from inferior, central and superior retina are essentially located laterally, centrally and medially, respectively, in the LGB, based on the electrophysiological studies of animal experiments and this observation has been applied to humans. This study radiologically shows that a discrete lateral lesion of the LGB produced homonymous upper quadrantanopia in case 1, whereas a more medially located lesion produced homonymous sectoranopia in case 2, and reveals that the axons originating from inferior retina are located more laterally than those from central retina in the human LGB.
Collapse
Affiliation(s)
- Naokatsu Saeki
- Departments of Neurological Surgery and Ophthalmology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuoh-ku, Chiba-shi, Chiba 260-8670, Japan.
| | | | | | | |
Collapse
|
33
|
Fujimoto N, Kubota M, Saeki N, Adachi-Usami E. Use of blue-on-yellow perimetry for detection of sectoranopia. Eye (Lond) 2004; 18:338-41. [PMID: 15004597 DOI: 10.1038/sj.eye.6700665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
34
|
|
35
|
|
36
|
Cassidy TP, Bruce DW, Gray CS. Visual field loss after stroke: Confrontation and perimetry in the assessment of recovery. J Stroke Cerebrovasc Dis 2001; 10:113-7. [PMID: 17903810 DOI: 10.1053/jscd.2001.25457] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2000] [Indexed: 11/11/2022] Open
Abstract
The purpose of this study was to examine the recovery of visual field deficits after first-ever stroke and to determine the accuracy of standard clinical assessment using oculokinetic perimetry. Of 148 patients with a hemisphere stroke and a normal conscious level, 75 (50.6%) were found to have a visual field deficit by clinical examination. Only 19 (11 women) stroke patients with visual field deficits were able to complete a perimetric examination within 1 week of their stroke. They were followed-up for a period of 12 weeks with serial clinical and perimetric examinations every 4 weeks. Clinical assessment of the patient failed to note further recovery after 4 weeks. By using oculokinetic perimetry, 8 (42.1%) patients recovered central vision but had a persistent peripheral field loss; maximal recovery of central vision was noted in the first 4 weeks. By using oculokinetic perimetry as the gold standard, the sensitivity of clinical assessment of visual field deficits was 94.4% on admission. The sensitivity fell to 55.5% during follow-up because of the clinicians' inability to detect central recovery by confrontation. The small numbers recruited show the difficult in recruiting acute stroke patients in measurements of recovery.
Collapse
Affiliation(s)
- T P Cassidy
- Department of Medicine, Royal Infirmary, University Geriatric Medicine Unit, Edinburgh, Scotland
| | | | | |
Collapse
|
37
|
Wong AM, Sharpe JA. A comparison of tangent screen, goldmann, and humphrey perimetry in the detection and localization of occipital lesions. Ophthalmology 2000; 107:527-44. [PMID: 10711892 DOI: 10.1016/s0161-6420(99)00092-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To compare manual kinetic perimetry with tangent screen and Goldmann techniques and automated static perimetry with the Humphrey Field Analyzer in the detection and localization of occipital lobe lesions. DESIGN Prospective consecutive comparative case series. PARTICIPANTS Twelve patients with well-defined occipital lobe infarcts on magnetic resonance (MR) imaging were studied. MAIN OUTCOME MEASURES The patients were tested by tangent screen, Goldmann, and Humphrey perimetry (central 30-2 threshold program). The three visual fields were compared and correlated with MR images. RESULTS All three perimetric techniques detected the presence of postchiasmal lesions. However, localization of lesions differed with perimetric technique. Visual fields obtained from tangent screen and Goldmann perimetry were similar and corresponded well with the location of lesions on MR images in all 12 patients. Humphrey perimetry inaccurately localized the lesion to the proximal part of the postchiasmal pathway by revealing incongruous fields in two patients, failed to detect sparing of the posterior occipital cortex or occipital pole in four patients, and estimated a larger extent of damage in one patient when compared with MR images and manual perimetry. CONCLUSIONS All three perimetric techniques are satisfactory screening tests to detect occipital lesions. However, tangent screen and Goldmann perimetry provide information about the location and extent of lesions that is more consistent with prevailing knowledge of the effects of the lesion in the postgeniculate visual pathway.
Collapse
Affiliation(s)
- A M Wong
- Department of Ophthalmology, University Health Network, Toronto Western Hospital, Ontario, Canada
| | | |
Collapse
|
38
|
Helekar SA. On the possibility of universal neural coding of subjective experience. Conscious Cogn 1999; 8:423-46; discussion 455-61. [PMID: 10600242 DOI: 10.1006/ccog.1998.0377] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Various neurophysiological experiments have revealed remarkable correlations between cortical neuronal activity and subjective experiences. However, the mere presence of neuronal electrical activity does not appear to be sufficient to produce these experiences. It has been suggested that the explanation for the neural basis of consciousness might lie in understanding the reason that some types of neuronal activity possess subjective correlates and others do not. Here I propose and develop the idea that this difference may be caused by the existence of an elementary nonarbitrary linkage between temporal or spatiotemporal patterns of neuronal activity and their subjective attributes. I also show how cortical neural circuits capable of generating experience-coding patterns could emerge during evolution and brain development, due to the presence of spontaneous stochastic neuronal activity and activity-dependent synaptic plasticity. This hypothesis leads to several testable predictions, principal among which is the idea that the neural correlates of consciousness are essentially innate and universal.
Collapse
Affiliation(s)
- S A Helekar
- Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
| |
Collapse
|
39
|
Abstract
We report a patient presenting with incongruous homonymous hemianopic scotoma due to infarction in the territory of the lateral posterior choroidal artery. Imaging studies showed that the patient had a fresh infarct in the lateral geniculate body causing this unusual visual field defect.
Collapse
Affiliation(s)
- K Wada
- Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan
| | | | | | | |
Collapse
|
40
|
Abstract
Posterior choroidal artery (PChA) territory infarcts remain the least well-known type of thalamic infarcts. Our study of 10 personal cases, selected from 2,925 stroke patients admitted consecutively to a community-based primary care center, and 10 published cases of unilateral PChA territory infarct suggests that they can often be differentiated clinically from other thalamic infarcts. Patients with PChA territory infarct associated with superficial posterior cerebral artery territory infarct or with another infarct were excluded. Damage was characteristically limited to the lateral geniculate body, pulvinar, posterior thalamus, hippocampus, and parahippocampal gyros, without involvement of the upper midbrain and the anterior nucleus of thalamus. In lateral PChA territory infarct, the most common clinical manifestations included homonymous quadrantanopsia, with or without hemisensory loss and neuropsychological dysfunction (transcortical aphasia, memory disturbances). A homonymous horizontal sectoranopsia is exceptional but particularly suggestive of the involvement of the lateral geniculate body in this territory. Media] PChA territory infarct was less frequent. Its neurologic picture was dominated by eye movement disorders not particularly suggestive of thalamic involvement. Late disability was usually absent or slight, being related to pain and delayed abnormal movements. The most common stroke etiology was presumed small-vessel occlusive disease.
Collapse
Affiliation(s)
- J P Neau
- Department of Neurology, University Hospital, Lausanne, Switzerland
| | | |
Collapse
|
41
|
Boschi A, Laterre C, Dehaene I, Voider AD. Central homonymous hemianopia with an ischaemic lesion of the anterior visual pathway. Neuroophthalmology 1994. [DOI: 10.3109/01658109409024064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|