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Sylvie Chokron, Carole Peyrin, Céline Perez
AIMS: Patients with homonymous hemianopia may present a subtle ipsilesional deficit, recently referred to as 'sightblindness' in addition to the contralesional visual field defect. We recently demonstrated that this deficit could be worse in right brain-damaged patients with left hemianopia than in left brain-damaged patients with right hemianopia, confirming right hemisphere dominance for visuo-spatial and attentional capacities. In the present study we investigate whether this ipsilesional deficit could be attentional in nature and to what extent it is comparable in right brain-damaged (RBD) patients with left hemianopia and in RBD patients with left neglect...
March 15, 2018: Neuropsychologia
Haiyong He, Wensheng Li, Chaofeng Liang, Lun Luo, Bo Hou, Huasheng Yang, Ying Guo
BACKGROUND: A pterional-orbital or subfrontal-orbital approach is recommended as a surgical treatment in cranio-orbital lesions. We describe a less invasive approach through an eyebrow incision combined supraorbital minicraniotomy and orbital osteotomy for treating some selected cranio-orbital lesions. METHODS: Sixteen patients with different cranio-orbital lesions were treated using this less invasive approach. Postoperative outcomes were evaluated to shed light on specific parameters related to this approach...
March 13, 2018: World Neurosurgery
Shuichi Tonomura, Tomoko Kitaichi, Rina Onishi, Yoshiaki Kakehi, Hisao Shimizu, Keiji Shimada, Kazuyuki Kanemasa, Akio Fukusumi, Nobuyuki Takahashi
BACKGROUND: A dural metastasis is one of the essential differential diagnoses of meningioma. In general, carcinomas of the breast and lung in females and prostate in males have been the most commonly reported primary lesions of dural metastases. However, dural metastasis of gallbladder carcinoma is extremely rare. Here, we report a unique case of a dural matter metastasis of gallbladder carcinoma as the first manifestation, which was autopsy-defined as small cell carcinoma. CASE PRESENTATION: A 78-year-old man came to our hospital complaining of left hemianopia...
March 16, 2018: World Journal of Surgical Oncology
Mirna Pineda-Ortíz, Gustavo Pacheco-López, Moisés Rubio-Osornio, Carmen Rubio, Juan Valadez-Rodríguez
RATIONALE: Visual therapy, which includes a restorative and compensatory approach, seems to be a viable treatment option for homonymous defects of the visual field in patients with postgeniculate injury of the visual pathway, due to occipital arteriovenous malformation (AVM). Until now, the Mexican population suffering from homonymous hemianopia did not have health services that provided any type of visual therapy for their condition. PATIENT CONCERNS: A 31-year-old patient, who underwent a surgical procedure for resection of the AVM, was referred with posterior low vision on the left side...
March 2018: Medicine (Baltimore)
Koji Tanaka, Toshiyuki Uehara, Kazumi Kimura, Yasushi Okada, Yasuhiro Hasegawa, Norio Tanahashi, Akifumi Suzuki, Jyoji Nakagawara, Kazumasa Arii, Shinji Nagahiro, Kuniaki Ogasawara, Shinichiro Uchiyama, Masayasu Matsumoto, Koji Iihara, Kazunori Toyoda, Kazuo Minematsu
BACKGROUND: A transient visual symptom (TVS) is a clinical manifestation of transient ischemic attack (TIA). The aim of this study was to investigate differences in clinical characteristics among subtypes of TVS using multicenter TIA registry data. MATERIALS AND METHODS: Patients with TIA visiting within 7 days of onset were prospectively enrolled from 57 hospitals between June 2011 and December 2013. Clinical characteristics were compared between patients with 3 major subtypes of TVS (transient monocular blindness [TMB], homonymous lateral hemianopia [HLH], and diplopia)...
March 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Rune Skovgaard Rasmussen, Anne Marie Heltoft Schaarup, Karsten Overgaard
BACKGROUND: Serious and often lasting vision impairments affect 30% to 35% of people following stroke. Vision may be considered the most important sense in humans, and even smaller permanent injuries can drastically reduce quality of life. Restoration of visual field impairments occur only to a small extent during the first month after brain damage, and therefore the time window for spontaneous improvements is limited. One month after brain injury causing visual impairment, patients usually will experience chronically impaired vision and the need for compensatory vision rehabilitation is substantial...
February 27, 2018: JMIR Research Protocols
G Cossu, R T Daniel, P Francois, C Destrieux, M Messerer
BACKGROUND: Isolated sphenoid mucoceles are rare, but due to their close proximity to important vasculonervous structures, local extension may result in serious consequences. CASE DESCRIPTION: A 47-year old patient presented with headaches, meningismus and a left homonymous lateral hemianopia. We report here the atypical evolution of a post-traumatic sphenoid mucocele invading the sellar region and extending into the subarachnoid space with compression of the right optic tract and we describe its surgical management...
February 10, 2018: World Neurosurgery
Rimal H Dossani, Devi P Patra, Christopher Storey, Piyush Kalakoti, Hai Sun
Objective  The video stars orbitozygomatic resection of Rathke's cleft cyst with suprasellar extension in a 37-year-old male patient presenting with severe headaches and bitemporal hemianopia. Clinical and radiological characteristics along with surgical technique (positioning, bony opening, surgical dissection and debulking, closure), histopathology, and postoperative course are described. Methods  Preoperative MRI demonstrated a noncontrast-enhancing cystic lesion in the sella with suprasellar extension causing compression of both optic nerves...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Sachin Ranganatha Goudihalli, Hiroki Morisako, Wimba Prastarana, Takeo Goto, Hiroki Ohata, Kenji Ohata
Retrochiasmatic craniopharyngiomas (RC) are a challenge for the neurosurgeon to treat surgically, restrained by their location in the interpeduncular fossa, surrounded by vital neurovascular structures, narrow corridor and poor visibility. Many approaches are possible and elucidated in the literature, which the surgeon chooses, based on multiple factors, such as the size of tumor, calcification, laterality, preoperative neurological deficits and the endocrine function status, recurrence, postradiotherapy status, or significant superior and/or posterior extension...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Mahmoud Messerer, Rodolfo Maduri, Roy Thomas Daniel
Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Kevin E Houston, Eli Peli, Robert B Goldstein, Alex R Bowers
Purpose: Drivers with homonymous hemianopia (HH) were previously found to have impaired detection of blind-side hazards, yet in many jurisdictions they may obtain a license. We evaluated whether oblique 57Δ peripheral prisms (p-prisms) and perceptual-motor training improved blind-side detection rates. Methods: Patients with HH (n = 11) wore p-prisms for 2 weeks and then received perceptual-motor training (six visits) detecting and touching stimuli in the prism-expanded vision...
January 2018: Translational Vision Science & Technology
Anna Nowakowska, Alasdair D F Clarke, Arash Sahraie, Amelia R Hunt
The impact of visual field deficits such as hemianopia can be mitigated by eye movements that position the visual image within the intact visual field. Effective eye movement strategies are not observed in all patients, however, and it is not known whether persistent deficits are due to injury or to pre-existing individual differences. Here we examined whether repeated exposure to a search task with rewards for good performance would lead to better eye movement strategies in healthy individuals. Participants were exposed to simulated hemianopia during a search task in five testing sessions over five consecutive days and received monetary payment for improvements in search times...
January 18, 2018: Neuropsychologia
Chiara Mazzi, Chiara Francesca Tagliabue, Gaetano Mazzeo, Silvia Savazzi
Patients with hemianopia can present with the so called blindsight phenomenon: the ability to perform above chance in the absence of acknowledged awareness. Proper awareness reports are, thus, crucial to distinguish pure forms of blindsight from forms of conscious, yet degraded, vision. It has in fact been recently shown that 1) dichotomous and graded measures to assess awareness can lead to different behavioural results in patients with hemianopia and that 2) different grades of perceptual clarity show different electrophysiological correlates in healthy participants...
January 16, 2018: Neuropsychologia
Manja Haaga, Susanne Trauzettel-Klosinski, Anna Krumm, Stephan Küster, Iliya Ivanov, Angelika Cordey, Claudia Gehrlich, Martin Staudt
AIM:  Diagnosing homonymous hemianopia (HH) in children can be difficult due to inability to comply with perimetry. Therefore, HH can often only be suspected by magnetic resonance imaging (MRI) showing lesions to the retrochiasmatic visual pathways. The aim of our retrospective observational cross-sectional study was to improve the radiologic detection of HH. METHODS:  MRIs of 21 subjects (5-17 years old) with ophthalmologically confirmed HH (14 complete, 7 incomplete hemianopias) were analyzed...
January 19, 2018: Neuropediatrics
K L Hanna, F J Rowe
The aim of this study was to identify which treatments for post-stroke visual impairment have a supportive evidence base, and which are being used in practice without supportive evidence. A systematic review of the literature reporting on the available treatment options was compared against the visual treatments used in the Vision In Stroke (VIS) study. Treatments were identified for visual field, visual neglect, visual perception and ocular motility disorders. Visual scanning therapies for hemianopia and neglect have an established evidence base...
December 2017: Neuro-ophthalmology
Sameen Haque, Kate Reid, Ross O'Neil, Christian Lueck
Intrinsic cystic lesions in the optic chiasm are an uncommon cause of bitemporal hemianopia compared with compressive lesions extrinsic to the chiasm. A 40-year-old man presented with difficulty driving. Clinical assessment revealed a bitemporal hemianopia. Magnetic resonance imaging showed an unusual cystic appearance of the chiasm. The appearance was felt to be most likely secondary to previous infective or inflammatory disease, but biopsy was not undertaken given the very significant risk of further visual loss...
August 2017: Neuro-ophthalmology
Matteo Sozzi, Stefania Bianchi Marzoli, Lisa Melzi, Massimo Corbo, Irene Venturella, Michela Balconi
It is widely known that visuospatial neglect and hemianopia maybe superimposed. We considered the differences in implicit information processing which is effective in patients with neglect but not with hemianopia. We then hypothesize that a prime-word in the neglected field should determine a semantic activation effect but not in a blind hemifield. Moreover eye movements could provide further details. In this work we considered a patient with a bilateral with the presence of either a left visual neglect and a right homonymous hemianopia...
October 2017: Neuro-ophthalmology
Wadim Bowl, Robert Knobloch, Silke Schweinfurth, Kerstin Holve, Knut Stieger, Birgit Lorenz
PURPOSE: To correlate visual field assessment with saccadic vector optokinetic perimetry (SVOP) in children with ganglion cell loss due to anterior pathway pathologies resulting in hemianopic visual field defects measured with optical coherence tomography (OCT). METHODS: 5 young (aged 3-6 years) and 5 adult patients with hemianopia, 10 healthy preschoolers (mean age 4.4 years), and 10 healthy adults (mean age 25.3 years) were tested with SVOP and OCT (focusing on the ganglion cell layer, GCL+)...
January 13, 2018: Ophthalmic Research
Hiroshi Sawachika, Shoko Kodama, Tomoyuki Mukai, Yoshitaka Morita
Lymphocytic hypophysitis (LHP) is a relatively rare disease characterised by lymphocytic infiltration of the pituitary gland, resulting in pituitary dysfunction. LHP is generally responsive to corticosteroid therapy, but cases with recurrence require clinicians to select second-line therapy. We report here the case of a 58-year-old patient with LHP who developed panhypopituitarism and bitemporal hemianopia. He responded to prednisolone 40 mg/day but relapsed during tapering. The prednisolone dose was increased again and mycophenolate mofetil (MMF) was added...
January 6, 2018: BMJ Case Reports
Aline Astorga-Carballo, Juan Carlos Serna-Ojeda, Mayra Fabiola Camargo-Suarez
Purpose: To present the clinical characteristics of a group of patients with the diagnosis of chiasmal syndrome who attended a large ophthalmological institute. Methods: Retrospective, observational clinical study with the review of medical records of patients with a diagnosis of chiasmal syndrome. The following variables were assessed: demographic characteristics, chief complaint upon presentation, best-corrected visual acuity (BCVA), presence or absence of diplopia, pupillary responses, optic nerve head morphology, etiology, and results from the ancillary tests including Ishihara test, Goldmann visual field (GVF) perimetry and neuroimaging...
October 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
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