Kitajima M, Korogi Y, Kido T, Ikeda O, Morishita S, Takahashi M
Department of Radiology, Kumamoto University School of Medicine, Japan.
Neuroradiology. 1998 Nov;40(11):710-5. doi: 10.1007/s002340050669.
We reviewed the MRI studies of 25 patients with occipital lobe infarcts to clarify the distribution of infarcts in the posterior cerebral arterial territory, focussing on their relationship to the striate cortex. Visual field defects and MRI findings were also correlated in 16 patients. On coronal and/or sagittal images, the distribution of the infarct and its relationship to the striate cortex were classified. Involvement of the cortex of both upper and lower lips of the calcarine fissure was observed in 10 patients, and involvement of the lower lip alone in 15. The upper cortical lesions were always accompanied by lower cortical lesions. The visual field defects were complete hemianopia in nine patients, superior quadrantanopia in six and hemianopia with a preserved temporal crescent in one. All patients with superior quadrantanopia had involvement of the lower cortex alone; there were no cases of inferior quadrantanopia. The characteristic vascular anatomy, and poor development of the collateral circulation in the lower cortical area, may explain the vulnerability of this area to infarcts.
我们回顾了25例枕叶梗死患者的MRI研究，以明确大脑后动脉供血区域梗死的分布情况，重点关注其与纹状皮质的关系。我们还对16例患者的视野缺损情况与MRI表现进行了相关性分析。在冠状面和/或矢状面上，对梗死的分布及其与纹状皮质的关系进行了分类。10例患者的距状裂上下唇皮质均受累，15例患者仅下唇皮质受累。上皮质病变总是伴有下皮质病变。视野缺损表现为9例患者为完全性偏盲，6例为上象限盲，1例为保留颞侧月牙的偏盲。所有上象限盲患者均仅下皮质受累；无下象限盲病例。其独特的血管解剖结构以及下皮质区域侧支循环发育不良，可能解释了该区域易发生梗死的原因。
