外伤性视交叉病变导致的半视野缺损。

Hemifield slide from traumatic optic chiasmopathy.

作者信息

Pula John H, Fischer Matthew, Kattah Jorge C

机构信息

NorthShore University Health System, 2650 Ridge Avenue, Evanston, IL 60201, USA.

University of Illinois College of Medicine, Peoria, IL, USA.

出版信息

J Clin Neurosci. 2014 Aug;21(8):1446-7. doi: 10.1016/j.jocn.2014.01.001. Epub 2014 Jan 24.

DOI:10.1016/j.jocn.2014.01.001

PMID:24613428

Abstract

A 56-year-old man suffered a high velocity linear acceleration closed head injury, resulting in skull fractures including bone dehiscence at the planum sphenoidale and tuberculum sellae. After regaining consciousness, he reported blurry vision and episodic diplopia. Visual field testing showed a bitemporal hemianopia. Ocular motility testing uncovered no misalignment. Brain MRI revealed post-traumatic encephalomalacia within the optic chiasm, resulting in the visual field defect and subsequent hemifield slide. Normally, cerebral processing of overlap between the visual fields prevents hemifield slide, which is caused by episodic loss of visual field overlap with subsequent slipping or sliding apart of images.

摘要

一名56岁男性遭受高速线性加速闭合性颅脑损伤，导致颅骨骨折，包括蝶骨平台和鞍结节处的骨质缺损。意识恢复后，他报告视力模糊和发作性复视。视野检查显示双颞侧偏盲。眼球运动测试未发现眼球偏斜。脑部磁共振成像显示视交叉内创伤后脑软化，导致视野缺损及随后的半视野滑动。正常情况下，大脑对视野重叠部分的处理可防止半视野滑动，半视野滑动是由视野重叠的间歇性丧失以及随后图像的滑动或分开所致。