脑梗塞的同向偏盲:病例报告

Hadwer Wicaksono Pandjaitan
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摘要

摘要 简介:同向偏盲是一种视野缺损,其特征是每只眼睛都丧失一半的视野。枕叶脑梗塞是同向偏盲最常见的病因。突发视野缺损应考虑为脑梗塞,以便及时处理。病例示例:男性,43 岁,3 个月前左侧双眼视力变暗,突然出现症状。患者有高血压(+)和高胆固醇血症(+)病史。眼科检查显示双眼视力均为 6/6,瞳孔反射正常,眼底镜检查正常。汉弗莱视野周视测试显示左侧同向偏盲。脑部 CT 扫描检查显示,双侧右枕叶、小脑和基底节多发脑梗塞。患者被转到神经内科接受进一步治疗。讨论:视野缺损模式可用于预测视觉通路的病变位置。枕叶病变可能出现的神经系统症状是先兆偏头痛和视幻觉。该患者出现左侧同向偏盲,脑CT扫描结果显示右枕叶多发脑梗塞。结论:同向偏盲的表现可预测脑梗塞的存在,因此在出现视野缺损时,可将其作为颅内异常的预测指标,以便与神经内科合作进行进一步评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HOMONYMOUS HEMIANOPIA IN CEREBRAL INFARCTION: CASE REPORT
Abstract Introduction : Homonymous hemianopsia is a visual field defect characterized by loss of half of the visual field in each eye. Cerebral infarction in the occipital lobe is the most common cause of homonymous hemianopsia. Sudden visual field loss should be considered as a cerebral infarction for prompt management. Case Illustration : Male 43 years old, vision in both eyes appears dark on the left side since 3 months ago, complaints occur suddenly. Patients with a history of hypertension (+) hypercholesterolemia (+). Ophthalmological examination revealed visual acuity in both eyes 6/6 with normal pupillary reflexesand normal fundoscopy in both eyes. Humphrey's visual field perimetry test showed left homonymous hemianopsia. A brain CT scan examination showed multiple cerebral infarctions in the right occipital lobe, cerebellum and basal ganglia bilaterally. The patient was referred to the neurology department for further treatment. Discussion : The visual field defect pattern is used to predict the location of the lesion in the visual pathway. Neurologic symptoms that may be present in occipital lobe lesions are migraine with aura and visual hallucinations. The patient had left homonymous hemianopsia where the results of brain CT scan showed multiple cerebral infarctions in the right occipital lobe. Conclusion : Manifestations of homonymous hemianopsia can predict the presence of cerebral infarction so that in the presence of visual field defects it can be used as a predictor of intracranial abnormalities for further evaluation and collaboration with the neurology department.
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