Natural history of homonymous hemianopia

Zhang, X.; Kedar, Sachin; Lynn, Michael; Newman, Nancy J.; Biousse, Valérie

doi:10.1212/01.wnl.0000203338.54323.22

Cited by 285 publications

(191 citation statements)

References 15 publications

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“…In humans, V1 injury is typically followed by a brief period of spontaneous recovery, which rarely lasts beyond 6 mo (32). Whether this recovery is the result of true visual system plasticity or is related to the gradual resolution of perilesional edema and general clinical improvement of the patients is unclear.…”

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confidence: 99%

Population receptive field analysis of the primary visual cortex complements perimetry in patients with homonymous visual field defects

Papanikolaou

Keliris

Papageorgiou

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Injury to the primary visual cortex (V1) typically leads to loss of conscious vision in the corresponding, homonymous region of the contralateral visual hemifield (scotoma). Several studies suggest that V1 is highly plastic after injury to the visual pathways, whereas others have called this conclusion into question. We used functional magnetic resonance imaging (fMRI) to measure area V1 population receptive field (pRF) properties in five patients with partial or complete quadrantic visual field loss as a result of partial V1+ or optic radiation lesions. Comparisons were made with healthy controls deprived of visual stimulation in one quadrant ["artificial scotoma" (AS)]. We observed no large-scale changes in spared-V1 topography as the V1/V2 border remained stable, and pRF eccentricity versus cortical-distance plots were similar to those of controls. Interestingly, three observations suggest limited reorganization: (i) the distribution of pRF centers in spared-V1 was shifted slightly toward the scotoma border in 2 of 5 patients compared with AS controls; (ii) pRF size in spared-V1 was slightly increased in patients near the scotoma border; and (iii) pRF size in the contralesional hemisphere was slightly increased compared with AS controls. Importantly, pRF measurements yield information about the functional properties of spared-V1 cortex not provided by standard perimetry mapping. In three patients, spared-V1 pRF maps overlapped significantly with dense regions of the perimetric scotoma, suggesting that pRF analysis may help identify visual field locations amenable to rehabilitation. Conversely, in the remaining two patients, spared-V1 pRF maps failed to cover sighted locations in the perimetric map, indicating the existence of V1-bypassing pathways able to mediate useful vision.cortical blindness | quadrantanopia | plasticity | retinotopy | hemianopia C ortical damage of the visual pathway often results from posterior or middle cerebral artery infarcts, hemorrhages, and other brain injuries. The most common visual cortex lesions involve the primary visual cortex (V1), the chief relayer of visual information to higher visual areas. Damage to area V1 or its primary inputs leads to the loss of conscious vision in the corresponding region of the contralateral visual hemifield, producing a dense contralateral scotoma that often covers a hemifield (hemianopia) or a single visual field quadrant (quadrantanopia).A much-debated issue is whether the adult V1 is able to reorganize after injury. Reorganization refers to long-term changes in the neuronal circuit (1) and generally requires the growth of new anatomic connections or a permanent change in the strength of existing connections. Several studies report significant remapping in area V1 of patients suffering from macular degeneration and other retinal lesions (2-12). The extent of this remapping has recently been called into question, however (1,(13)(14)(15)(16)(17)(18)(19). Less is known about how the visual system remaps to cover the visual field after injury to a...

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confidence: 99%

Population receptive field analysis of the primary visual cortex complements perimetry in patients with homonymous visual field defects

Papanikolaou

Keliris

Papageorgiou

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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“…Most of the data available come from studies that not only involved vascular causes of hemianopia but also included also tumors, trauma, and other changes. 3 Recovery is maximal within 48 hours and occurs up to 10 days, and it is minimal after 3 months. Hemianopia of vascular origin has the worst prognosis for spontaneous recovery.…”

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confidence: 99%

“…Hemianopia of vascular origin has the worst prognosis for spontaneous recovery. 3,4 We previously identified 3 patients with isolated homonymous hemianopia among 1427 intravenous thrombolysis-treated stroke patients in the Helsinki Stroke Thrombolysis Registry and reported excellent outcomes in all of them. 5 Therefore, we aimed to analyze the same phenomenon in the largest stroke thrombolysis database, the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR).…”

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confidence: 99%

Intravenous Thrombolysis in Ischemic Stroke Patients With Isolated Homonymous Hemianopia

Strbian

Ahmed

Wahlgren

et al. 2012

Stroke

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on behalf of SITS InvestigatorsBackground and Purpose-Hemianopia can cause considerable disability. Only scarce data are available for ischemic stroke patients presenting with isolated homonymous hemianopia and being treated with intravenous thrombolysis. We analyzed outcome of such patients registered in the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR). Methods-The SITS-ISTR (nϭ45 079) was searched for patients who presented with isolated homonymous hemianopia.We identified 72 such patients. We report their baseline and demographic characteristics, radiological data, change in their National Institutes of Health Stroke Scale score within 7 days after thrombolysis, and their 3-month modified Rankin Scale (mRS) score. Univariate analysis of parameters associated with any improvement was performed. Hemianopia was assessed with perimetric examination. Results-Of 72 patients, 40 (56%) improved within 7 days after thrombolysis; 19 (26%) had full recovery. Those who improved had significantly lower systolic blood pressure before thrombolysis and were less often administered antiplatelet agents before index stroke. Infarction was visible on 24-hour computed tomography scan in 65% of patients who improved compared with 81.2% of those without improvement (Pϭ0.32). No symptomatic intracranial hemorrhage occurred in patients who improved compared with 1 (3.1%) patient in the nonimproved group (Pϭ0.08). Seventy-one percent of all patients had 3-month mRS score 0 to 2, and 51% had mRS score 0 to 1. Those who improved within 7 days had a significantly better 3-month outcome (median mRS [interquartile range], 0 [0 -1] vs 2 [1-2]). Conclusions-Relatively few ischemic stroke patients received thrombolysis because of isolated homonymous hemianopia. Thrombolysis seems to be safe in these patients. Of those treated, more than half improved and more than two-thirds had good outcome. (Stroke. 2012;43:2695-2698.)

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“…This is emphasised by the finding that spontaneous improvement of homonymous hemianopia decreases with the time to the patient's first evaluation, suggesting that the sooner the rehabilitation begins, the more likely it is that recovery may be facilitated. 21 In summary, traumatic homonymous hemianopia occurs more commonly in young men, and as a consequence of a wide variety of head injuries. They often occur in the setting of multiple brain lesions and are associated with other neurological deficits.…”

Section: -11mentioning

confidence: 99%