Jang Sung Ho, Seo Jeong Pyo
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
Medicine (Baltimore). 2017 Jul;96(29):e7356. doi: 10.1097/MD.0000000000007356.
Little is known about optic radiation (OR) injury following aneurysmal subarachnoid hemorrhage (SAH). In the current study, we report on a patient who showed a visual field defect and injury of the OR following aneurysmal SAH, using diffusion tensor tractography (DTT).
At 4 weeks from onset, when a 62-year old female started rehabilitation, she complained of a visual field defect. Peripheral field defects were detected on both eyes using the Humphrey visual field test.
The patient underwent aneurysm clipping for a ruptured aneurysm in the left posterior communicating artery and extraventricular drainage (the left prefrontal approach) for subarachnoid hemorrhage. She also underwent conservative management for intracerebral hemorrhage in the left internal capsule detected at 2 days after onset.
DTT data were acquired at 4 weeks after onset OUTCOMES:: Regarding DTT parameters, fiber numbers of both ORs of the patient were decreased over 2 standard deviations of that of 7 age- and sex-matched normal subjects normal control subjects. However, the value of fractional anisotropy was similar to that of normal control subjects. On the configuration of the OR of the patient, both ORs were thinner than those of normal control subjects.
Injury of the OR was demonstrated in a patient with a visual field defect following aneurysmal SAH, using DTT.
关于动脉瘤性蛛网膜下腔出血（SAH）后的视辐射（OR）损伤，目前所知甚少。在本研究中，我们报告了一名动脉瘤性SAH后出现视野缺损和OR损伤的患者，采用了弥散张量纤维束成像（DTT）技术。
发病4周时，一名62岁女性开始康复治疗，她主诉有视野缺损。使用Humphrey视野测试在双眼检测到周边视野缺损。
患者因左侧后交通动脉破裂动脉瘤接受了动脉瘤夹闭术，并因蛛网膜下腔出血接受了脑室外引流（左前额叶入路）。她还对发病后2天检测到的左侧内囊脑出血进行了保守治疗。
在发病4周后采集DTT数据。
关于DTT参数，患者双侧OR的纤维数量比7名年龄和性别匹配的正常对照受试者的纤维数量减少超过2个标准差。然而，各向异性分数的值与正常对照受试者相似。在患者OR的形态上，双侧OR均比正常对照受试者的细。
使用DTT技术在一名动脉瘤性SAH后出现视野缺损的患者中证实了OR损伤。
