心室細動を伴い両側同名半盲を来した1症例  [in Japanese] Bilateral Homonymous Hemianopsia with Atrial Fibrillation  [in Japanese]

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Abstract

症例は80歳の男性. 突然の両眼視力障害を主訴に入院した. 入院時, 血圧138/70mmHg, 心電図上心房細動を示した. 神経学的所見では両眼視力低下 (両眼光覚弁) のみを認め, 麻痺や発語障害, 眼球運動異常や眼振はいずれも認めなかった. 頭部MRIにて両側後頭葉に脳梗塞が認められた. 精密視野測定にて両側性の同名半盲を認め, 左同名半盲は黄斑部回避をしていた. 本症例では両側同名半盲のみを認めており, 脳底動脈領域閉塞の中でも特に後大脳動脈の深部枝を出した後の皮質枝のみが両側性に閉塞したものと考えられた.

We encountered an 80-year-old man with sudden bilateral visual disturbance. When he was admitted to the hospital, his blood pressure was 138/70mmHg, and an ECG revealed atrial fibrillation. Neurological examination showed only bilateral homonymous hemianopsia with no nystagmus or impairment of eye movement. He did not have paralysis, cerebellar ataxia, or speech disturbance. Therefore, there was no evidence of obstruction of the thalamogeniculate or thalamoperforating artery. Magnetic resonance imaging of the brain showed cerebral infarctions in both occipital lobes. Perimetry showed bilateral homonymous hemianopsia; the left side of the macula was spared. The lack of neurological deficit other than bilateral homonymous hemianopsia indicates that only the right and left cortical branches of the posterior cerebral artery were occluded.

Journal

  • Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 35(9), 691-694, 1998-09-25

    The Japan Geriatrics Society

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