Clinicoradiologic Findings and Prognosis of Cortical Blindness.
- Author:
Jung Eun KIM
1
;
Kee Duk PARK
;
Jee Young OH
;
Jee Hyun KIM
;
Young Joo KWON
;
Yong Jae KIM
;
Kyoung Gyu CHOI
Author Information
1. Department of Neurology, College of Medicine, Ewha Womans University, Korea. pkd1165@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Cortical blindness;
Occipital lobe;
Posterior cerebral artery;
Extracalcarine cortex;
Prognosis
- MeSH:
Blindness;
Blindness, Cortical*;
Eclampsia;
Electroencephalography;
Evoked Potentials, Visual;
Female;
Fingers;
Follow-Up Studies;
Headache;
Heart Arrest;
Humans;
Infarction;
Infarction, Posterior Cerebral Artery;
Neurologic Examination;
Occipital Lobe;
Posterior Cerebral Artery;
Postpartum Period;
Pregnancy;
Prognosis*;
Visual Acuity
- From:Journal of the Korean Neurological Association
2002;20(4):359-364
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Cortical blindness is one of the less known clinical syndromes caused by bilateral occipital lobe lesions. The most common etiology is bilateral posterior cerebral artery (PCA) infarction, and the prognosis has been reported to be bad and incomplete. METHODS: We reviewed our registry from January 1999 to March 2002, and found seventeen patients who were diagnosed with cortical blindness. We analyzed their clinical features, neurologic examinations, radiologic findings, electrophysiological studies, and follow up their visual acuities. RESULTS: Of the sixteen cases, ten were bilateral PCA infarction, three were postpartum eclampsia, two were cyclosporin-induced blindness and the other was the case recovered from cardiac arrest. Most patients' presenting symptoms were headache and sudden visual loss, ranged from finger count to complete blindness. There were two patients with complete blindness. On the follow up examination, twelve patients regained some visual acuity. The wider lesion involved bilateral occipital lobes; the worse was initial visual acuity. The prognosis was better when the lesion size was small and extrastriate cortex was spared. The electroencephalography and visual evoked potential findings were compatible with clinical symptom, but not exactly correlated with the prognosis. CONCLUSIONS: Contrary to the general concept that cortical blindness is caused by bilateral occipital lobe infarction has a poor prognosis, our cases showed a fair outcome of vision. It was a good predictor for prognosis whether extrastriate cortex was spared or not, suggesting its role in visual recovery.
