Saeki Naokatsu, Fujimoto Naoya, Kubota Motoo, Yamaura Akira
Departments of Neurological Surgery and Ophthalmology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuoh-ku, Chiba-shi, Chiba 260-8670, Japan.
Clin Neurol Neurosurg. 2003 Dec;106(1):28-32. doi: 10.1016/j.clineuro.2003.08.002.
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.
高分辨率磁共振成像显示了两例可能因缺血导致外侧膝状体(LGB)部分损伤的罕见病例。一名62岁女性(病例1)在Goldmann视野检查中表现为左侧同向性上象限盲。重T2加权磁共振图像显示LGB外侧部分有局限性病变。视野缺损不累及黄斑和水平子午线,持续了9年。一名49岁女性(病例2)在Humphrey自动视野检查中突然出现左侧同向性水平扇形盲,重T2加权图像显示右侧LGB更内侧部分有病变。根据动物实验的电生理研究,起源于视网膜下、中央和上部的轴突在LGB中分别基本位于外侧、中央和内侧,这一观察结果也适用于人类。本研究通过影像学显示,病例1中LGB离散性外侧病变导致同向性上象限盲,而病例2中更内侧的病变导致同向性扇形盲,并揭示了在人类LGB中,起源于视网膜下部的轴突比起源于中央视网膜的轴突更靠外侧。