Kiriyama K, Yoshimura T, Furuya H, Kobayashi T, Hasuo K
Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka.
Rinsho Shinkeigaku. 1996 Jul;36(7):902-5.
A 54-year-old man was admitted to the hospital because of the restriction of the right visual field. Goldmann's visual field test revealed the right central hemianopsia. MRI showed the infarction of the left occipital lobe tip. Cerebral angiography showed the occlusion of the left calcarine artery but no abnormality in the branches of the middle cerebral artery (MCA). The occipital lobe tip receives the projection from the macular area and is supplied by both calcarine artery and a branch of MCA. Therefore, cases of central homonymous hemianopsia due to vascular disorders have been relatively rare and the macular vision is usually spared. In contrast to the above knowledge, only one artery occlusion resulted in the central hemianopsia in our case. Poor anastomosis between PCA and MCA in the occipital tip of our patient may explain occurrence of the infarction of that area.
一名54岁男性因右侧视野受限入院。戈德曼视野检查显示右侧中央偏盲。磁共振成像（MRI）显示左侧枕叶尖端梗死。脑血管造影显示左侧距状动脉闭塞，但大脑中动脉（MCA）分支无异常。枕叶尖端接受黄斑区的投射，由距状动脉和MCA的一个分支供血。因此，血管性疾病导致的中央同向性偏盲病例相对少见，黄斑视力通常不受影响。与上述知识相反，在我们的病例中，仅一条动脉闭塞就导致了中央偏盲。我们患者枕叶尖端PCA和MCA之间吻合不良可能解释了该区域梗死的发生。
