Prognostic Factors for Long-Term Recovery of Homonymous Visual Field Defects After Posterior Circulation Ischemic Stroke

Cárdenas-Belaunzarán, Jorge; Cano-Nigenda, Vanessa; A, Barboza Miguel; González-Olhovich, Irene; Araúz, Antonio

doi:10.1016/j.jstrokecerebrovasdis.2021.105924

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Visual field deficits showed with 27.3%, the poorest improvement rate following surgery, which is in accordance with a recent study reporting only 16% recovery rate of visual field deficits in NSBM patients following surgical resection ( 24 ). Interestingly, studies summarizing focal neurological improvement rates in stroke patients also demonstrated a significantly worse recovery rate in visual field deficits ( 50 , 51 )compared to hemiparesis ( 52 ) or aphasia ( 53 , 54 ). The most probable reason for this observation is founded on the optic system’s highly organized retinotopic and cortical functionality ( 53 – 55 ), causing the comparably low functional re–organization rates ( 55 ).…”

Section: Discussionmentioning

confidence: 99%

Symptom burden and surgical outcome in non-skull base meningiomas

et al. 2022

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PurposeNon-skull base meningiomas (NSBM) are a distinct entity and frequently present with focal neurological deficits. This study was designed to analyze functional and oncological outcome following microsurgical tumor resection in patients with NSBM.Patients and methodsAn analysis of 300 patients that underwent NSBM resection between 2003 and 2013 was performed. Assessment measures for functional outcome were Karnofsky Performance Scale (KPS), Medical Research Council - Neurological Performance Scale (MRC-NPS), and improvement rates of focal deficits and seizures. The extent of resection; recurrence-free survival (RFS) and tumor-specific survival (TSS) were also determined.ResultsImpaired KPS and MRC-NPS were present in 73.3% and 45.7%, respectively. Focal neurological deficits were recorded in 123 patients (41.0%), with hemiparesis (21.7%) and aphasia (9.3%) the most prevalent form of impairment. Most meningiomas were localized at the convexity (64.0%), followed by falcine tumors (20.3%). Both KPI and MRC-NPS scores were significantly improved by surgical resection. Postoperative improvement rates of 96.6%, 89.3%, 72.3%, 57.9%, and 27.3% were observed for aphasia, epilepsy, hemiparesis, cranial nerve, and visual field deficits, respectively. Long-term improvement was achieved in 83.2%, 89.3%, 80.0%, 68.4% and 54.6% of patients, respectively. Gross total resection (GTR) over subtotal resection (STR) significantly improved preoperative seizures and visual field deficits and correlated with reduced risk of new postoperative hemiparesis. Poor Simpson grade was the only significant prognostic factor in multivariate analysis for long-term functional deficit, which occurred in 7.3%. Median RFS was 45.9 months (6.0 - 151.5 months), while median TSS was 53.7 months (3.1 – 153.2 months). Both WHO grade (p= 0.001) and Simpson classification (p= 0.014 and p= 0.031) were independent significant prognostic factors for decreased RFS and TSS by multivariate analysis, respectively. Furthermore, tumor diameter > 50 mm (p= 0.039) significantly correlated with decreased TSS in multivariate analysis.ConclusionSurgical resection significantly and stably improves neurological deficits in patients with NSBM.

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Section: Discussionmentioning

confidence: 99%

Symptom burden and surgical outcome in non-skull base meningiomas

et al. 2022

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“…3 Younger patients (<50 yr) have a chance for visual recovery but complete homonymous hemianopia is a poor prognosis predictor at any age. 23 The patient suffering a minor stroke has a good chance for recovery compared to the patient who has gross neurological deficits at presentation and usually has poor or no guarantee of full recovery. 24…”

Section: Prognosismentioning

confidence: 99%

Posterior cerebral artery stroke with visual manifestation during COVID pandemic

Yasir,

Sharma,

Khandekar

et al. 2023

IJCEO

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The posterior cerebral artery (PCA) stroke represents 5% to 10% of total strokes. The number of stroke cases has increased during the Global pandemic of Covid 19. It can be challenging to diagnose PCA stroke presenting as a visual manifestation, as symptoms are nonspecific and variable over due course of time. This is more complex in patients who are not aware of their symptoms, and therefore difficult to establish a timeline of events. Mostly PCA stroke with only visual symptoms visits an ophthalmologist rather than an emergency attendee. Knowledge of the neurovascular anatomy of the brain is required to understand PCA stroke and identify the stroke’s mechanism to select appropriate therapies. In this article, we provide an overview of PCA stroke and focused on visual manifestations, diagnosis, and management of PCA stroke.

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“…The Goldmann visual field record revealed right homonymous hemianopsia (HH) ( Picture 2 ), and diffusion-weighted magnetic resonance imaging showed acute cerebral infarction in the left thalamus and occipital lobe ( Picture 3 ). Most cases of HH are induced by ischemic stroke ( 1 ), and approximately half of these cases are not self-detected by such patients in daily life ( 2 ). Early intervention using intravenous recombinant tissue plasminogen activator (rtPA) and mechanical thrombectomy has been identified as an important factor in the functional outcome of patients with ischemic stroke.…”

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confidence: 99%

Homonymous Hemianopsia Detected during a Meal

2022

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During dinner, a 74-year-old man ate food only from the left side of the dish, leaving the right side untouched (Picture 1). The Goldmann visual field record revealed right homonymous hemianopsia (HH) (Picture 2), and diffusionweighted magnetic resonance imaging showed acute cerebral infarction in the left thalamus and occipital lobe (Picture 3). Most cases of HH are induced by ischemic stroke (1), and approximately half of these cases are not self-detected by such patients in daily life (2). Early intervention using intravenous recombinant tissue plasminogen activator (rtPA) and

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Prognostic Factors for Long-Term Recovery of Homonymous Visual Field Defects After Posterior Circulation Ischemic Stroke

Cited by 5 publications

References 35 publications

Symptom burden and surgical outcome in non-skull base meningiomas

Symptom burden and surgical outcome in non-skull base meningiomas

Posterior cerebral artery stroke with visual manifestation during COVID pandemic

Homonymous Hemianopsia Detected during a Meal

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