枕叶脑梗塞后同向性偏盲的自然史

The Natural History of Homonymous Hemianopia in Patients with Occipital Infarction

随访４３例由一侧枕叶脑梗塞引起的同向性偏盲患者，其中同向性象限盲及同向性偏盲性中心暗点各３例，完全性同向偏盲３７例（８６％）。后者除２例死亡外，余３５例按４组连续随访年中不同转归的各组累计例数为正常视野１例，同向偏盲性中心暗点３例，同向性象限盲５例及完全性同向偏盲７４例，后者占总累积例数的８９％（７４／８３）。而随访４３例中非完全性同向偏盲６例的视野无变化。提示枕叶脑梗塞后同向性偏盲恢复较少，部分恢复也限于发病早期，视觉功能好转与可见视野扩大有关。

patients with homonymous hemianopia(HH) were studied retrospectively. 27 males,16 females; mean age 57. 8 years old; 23 with left occipital infarction, 20 with right.Of the 43 patients, 37(86%)complete HH, 3 homonymous quardrantanopia(HQ)and 3 homonymous central scotoma (HCS ) were successfully follow- up with the follow time of 17years. Of 37 complete HH, only 2 died , the cumulative numbers of different prognosis of 35 cases in 4 follow periods were that 74(89%)remained complete HH,5turned to HQ, 3 turned to HCS, 1 became normal. It is found that improvement of the patient′s visual performance is consistent with recovery of visual field.It is concluded that the recovery from HH with occipital infarction is partial, probably low and only takes place during early stage after damage.