罕见病例儿童同侧半身不遂

RAHAYU WIDHYASTI1, Antonia Kartika Indriati, Rusti Hanindya Sari, Dianita Veulina Ginting, Prettyla Yollamanda
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摘要

摘要 简介:同向偏盲(Homonymous hemianopia,HH)是由于影响后视丘视觉通路的许多病变导致的两眼同半视野缺损。儿童同向偏盲是一种罕见的致残性疾病,可能是脑肿瘤的最初表现。病例说明:一名 12 岁男孩主诉左侧视力部分丧失,伴有间歇性头痛。眼科检查显示双眼视力均为 1.0。视野检查显示左侧同侧偏盲(图 1)。这些结果与他的脑计算机断层扫描(CT)结果有关,CT 扫描显示右枕叶有血管肿块,怀疑是混合弥漫型动静脉畸形引起的(图 2)。患者被转诊至神经外科医生处接受进一步治疗。讨论:视野缺损取决于病变的位置,可用于识别视通路疾病。同向偏盲发生在后视网膜病变,可能发生在成人或儿童身上。儿童同向偏盲的异常表现由脑肿瘤(如动静脉畸形)引起。其发生率高达 27%,可通过脑 CT 扫描或磁共振成像(MRI)进行放射学检测。结论:儿童患者视野缺失可能具有挑战性。正确和及时的诊断对于发现潜在疾病和确定患者的进一步治疗方案非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A RARE CASE : HOMONYMOUS HEMIANOPIA IN CHILDREN
Abstract Introduction : Homonymous hemianopia (HH) is a visual field loss in the same halves of the visual field of each eye that is caused by numerous lesion affecting the retrochiasmal visual pathway. Homonymous hemianopia in children is a rare disabling condition and might be found as an initial presentation of brain tumors. Case Illustration : A 12 years old boy came with chief complaint of partially vision loss on the left side of vision accompanied by intermittent headache. Ophthalmological examination showed visual acuity of 1.0 on both eyes. Visual field examination revealed left homonymous hemianopia (figure 1). These findings were relevant to the result of his brain Computed Tomography (CT) scan, which showed vascular mass in the right occipital lobe caused by suspected arteriovenous malformation mixed diffuse type (figure 2). The patient was referred to neurosurgeon for further management. Discussion : Visual field defect depends on location of the lesion and can be used to recognize optic pathway diseases. Homonymous hemianopia occurs in retrochiasmal lesions that could happened either in adult or children. Unusual presentation of HH in children caused by brain tumor such as arteriovenous malformation. It might occur in up to 27% and can be detected radiologically with either brain CT scan or Magnetic Resonance Imaging (MRI). Conclusion : Visual field loss in pediatric patient might be challenging. Proper and prompt diagnosis is important to detect underlying condition and determine further management of the patient.
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