Keller H M, Meyer W E, Valavanis A, Imhof H G
Konsiliarius für Neuroangiologie, Hochhaus zur Schanze, Zürich.
Klin Monbl Augenheilkd. 1988 May;192(5):532-42. doi: 10.1055/s-2008-1050174.
Hemianopsia of vascular origin can be caused by diseases in the carotid circulation (optic tract, proximal third of the optic radiation), as well as in the vertebrobasilar arterial system (middle and distal thirds of the optic tract, striate area/calcarina). Hemianopsia of ischemic origin must be differentiated from hemianopia in the presence of an enlarging aneurysm, a space-occupying intracranial lesion (hemorrhage, neoplasia), and inflammatory disease, occasionally in metabolic disorders. To detect the exact cause of a hemianopia in a given patient, recording of the patient's precise history and clinical-neurological, clinical-ophthalmological, and clinical-internal examinations are mandatory, as well as additional diagnostic procedures. Of these, the most important are neurovascular ultrasound examinations (extracranial, transcranial and B-mode/duplex Doppler examination), CT and MRI scans, and cardiological examination with echocardiography. The choice of these additional and costly examinations and their sequence in the diagnostic work-up in a given patient has to be adapted to the patient.
血管性起源的偏盲可由颈动脉循环（视束、视辐射近端三分之一）以及椎基底动脉系统（视束中远端三分之一、纹状区/距状裂）的疾病引起。缺血性起源的偏盲必须与存在动脉瘤增大、颅内占位性病变（出血、肿瘤）、炎症性疾病以及偶尔的代谢紊乱时的偏盲相鉴别。为了在特定患者中检测偏盲的确切病因，记录患者的精确病史以及进行临床神经学、临床眼科和临床内科检查是必不可少的，还需要进行其他诊断程序。其中，最重要的是神经血管超声检查（颅外、经颅和B型/双功多普勒检查）、CT和MRI扫描以及超声心动图心脏检查。这些额外且昂贵的检查的选择及其在特定患者诊断工作中的顺序必须根据患者情况进行调整。
