視床近傍脳血管障害における視野異常 : 急性期視床出血を中心に

概要

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Fifty cases which hold cerebrovascular accidents with lesions near the thalamus were analized on the point of visual field and other ocular signs. Visual field was examined by Goldmann perimeter and the following point have been found. (1) The visual field defect was detected 9 cases (41%) out of 21 patients in acute phase of thalamic hemorrhages. (2) Their visual field defects were usually depressed in inferior quadrants and showed markable recovery and relative conguity in some of them. (3) Computed tomography and ocular fundus signs showed that these hemianopias were caused by enlargement of hematomas in infero-posterior location and main damaged lesions were supposed to be the optic peduncle near the lateral geniculate body. (4) Those who have putaminal hemorrhages which extended to posterior areas of post limb of internal capsel, also exhibited same hemianopias like the cases of acute phase of thalamic hemorrhage. (5) Conguity of visual field was thought to be not so significant in the diagnosis of localization of damaged lesions as reported before. (6) The estimation of visual field defect of sush cases should be based upon the various neuropsychological examinations. (7) The patients of above mentioned cases apt to have no complaints to visual disturbance, so that neurologist should give attention to such cases and remind of significance of ophthalmological examination.