Jang Sung Ho, Chang Chul Hoon, Jung Young Jin, Kim Seong Ho, Seo Jeong Pyo
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
Department of Neurosurgery, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
Neural Regen Res. 2018 Mar;13(3):563-566. doi: 10.4103/1673-5374.228763.
Visual field defect is one of the various clinical manifestations in patients with subarachnoid hemorrhage (SAH). Little is known about the pathogenic mechanism of visual field defect in SAH. In the current study, we investigated the diffusion tensor imaging (DTI) finding of the optic radiation in patients with SAH following rupture of a cerebral artery aneurysm. We recruited 21 patients with aneurismal SAH (12 males, 9 females, mean age, 52.67 years; range, 41-68 years) who showed no definite lesion along the visual pathway. Twenty-one age-and sex-matched normal control subjects were also recruited. DTI data were acquired at an average of 5.9 weeks (range: 3-12 weeks) after onset and reconstruction of the optic radiation was performed using DTI-Studio software. The fractional anisotropy value, apparent diffusion coefficient value, and fiber number of the optic radiation were measured. The fractional anisotropy value of the optic radiation was significantly decreased, and the apparent diffusion coefficient value was significantly increased, in patients with aneurismal SAH than in normal control subjects. However, there was no significant difference in the fiber number of the optic radiation between patients with aneurismal SAH and normal control subjects. The decrement of fractional anisotropy value and increment of apparent diffusion coefficient value of the optic radiation in patients with aneurismal SAH suggest optic radiation injury. Therefore, we recommend a thorough evaluation for optic radiation injury in patient with aneurismal SAH.
视野缺损是蛛网膜下腔出血（SAH）患者的多种临床表现之一。目前对于SAH患者视野缺损的发病机制知之甚少。在本研究中，我们调查了脑动脉瘤破裂后SAH患者视辐射的扩散张量成像（DTI）表现。我们招募了21例动脉瘤性SAH患者（男性12例，女性9例，平均年龄52.67岁；范围41 - 68岁），这些患者的视觉通路未发现明确病变。还招募了21名年龄和性别匹配的正常对照者。在发病后平均5.9周（范围：3 - 12周）采集DTI数据，并使用DTI-Studio软件对视辐射进行重建。测量视辐射的各向异性分数值、表观扩散系数值和纤维数量。与正常对照者相比，动脉瘤性SAH患者视辐射的各向异性分数值显著降低，表观扩散系数值显著升高。然而，动脉瘤性SAH患者与正常对照者视辐射的纤维数量没有显著差异。动脉瘤性SAH患者视辐射各向异性分数值的降低和表观扩散系数值的升高提示视辐射损伤。因此，我们建议对动脉瘤性SAH患者对视辐射损伤进行全面评估。
