QUADRANTIC VISUAL-FIELD DEFECTS - A HALLMARK OF LESIONS IN EXTRASTRIATE (V2/V3) CORTEX
QUADRANTIC VISUAL-FIELD DEFECTS - A HALLMARK OF LESIONS IN EXTRASTRIATE (V2/V3) CORTEX
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DOI：
10.1093/brain/114.4.1703
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发表时间：
1991-08-01
期刊：
影响因子：
14.5
通讯作者：
HOYT, WF
中科院分区：
文献类型：
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作者：
HORTON, JC;HOYT, WF
我们报告2例同名的象限视野缺陷患者。第一例患者在左下象限出现闪烁，导致在右枕叶楔形脑区发现星形细胞瘤。术后，她有左下象限视，精确地尊重水平经络。第二例患者表现为左下象限视，保留了中央10度视力，也尊重水平经络。从右上蠕动皮质切除一例星形细胞瘤，我们必须解释这2例患者纹外皮质病变如何产生同名的水平边缘的视野缺陷。V2区和V3区分别沿水平子午线被分成两半，分别位于纹状皮质两侧。因此，纹状体外皮质的上象限和下象限在物理上隔离在纹状体皮质的两侧。我们认为，涉及V2/V3的病变可能足以造成视野缺陷。虽然病变的边缘可能不规则，但如果穿过纹外皮质的水平子午线，由于V2/V3上、下象限的分裂布局，它将产生具有尖锐水平边界的四边形视野缺陷。
We report 2 patients with homonymous quadrantic visual field defects. The first patient experienced scintillations in the left lower quadrant, leading to the discovery of an astrocytoma in the cuneus of the right occipital lobe. Postoperatively she had a left lower quadrantanopia that precisely respected the horizontal meridian. The second patient presented with a left lower quadrantanopia, sparing the central 10-degrees of vision that also respected the horizontal meridian. An astrocytoma was resected from the right upper peristriate cortex.We must explain how a lesion in extrastriate cortex produced a homonymous field defect with a sharp horizontal edge in these 2 patients. Areas V2 and V3 are each divided along the horizontal meridian into separate halves flanking striate cortex. Consequently, the upper and lower quadrants in extrastriate cortex are physically isolated on opposite sides of striate cortex. We propose that a lesion involving V2/V3 may be sufficient to create a visual field defect. Although the lesion may have irregular margins, if it crosses the representation of the horizontal meridian in extrastriate cortex, it will produce a quadrantic visual field defect with a sharp horizontal border because of the split layout of the upper and lower quadrants in V2/V3.