Concurrent acute brain infarcts in patients with monocular visual loss.
Concurrent acute brain infarcts in patients with monocular visual loss.
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DOI：
10.1002/ana.23597
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发表时间：
2012-08
影响因子：
11.2
通讯作者：
Ay, Hakan
中科院分区：
文献类型：
--
作者：
Helenius, Johanna;Arsava, E. Murat;Goldstein, Joshua N.;Cestari, Dean M.;Buonanno, Ferdinando S.;Rosen, Bruce R.;Ay, Hakan
视网膜循环近端来源的栓塞可能是半球循环相同来源栓塞的征象。我们试图确定急性脑梗死的扩散加权成像（DWI）的单眼缺血性视力丧失（MVL）患者的频率。我们回顾性研究了129例继发于视网膜缺血的MVL患者。所有患者均接受了DWI、全面的眼科和神经系统检查以及潜在病因的诊断评估。统计分析探讨了急性脑梗死DWI证据的单变量和多变量预测因子。DWI显示129例患者中有31例（24%）并发急性脑梗死。栓塞性MVL的DWI阳性概率高于非栓塞性MVL（28% vs. 8%，p=0.04），以永久性视力丧失为特征的MVL高于一过性症状（33% vs. 18%，p=0.04），同时伴有半球症状的MVL高于孤立性MVL（53% vs. 20%，p<0.01）。与DWI正常的患者相比，DWI阳性的患者更有可能隐藏主要的潜在病因（OR 3.7，95% CI 1.5-9.4）。这项研究表明，MVL并不总是代表一个孤立的视网膜疾病，大约四分之一的MVL患者表现出急性脑梗死的DWI。由于并发脑梗死的患者更有可能表现出心脏或血管栓塞源，MVL患者脑损伤的影像学证据可能是一个有用的标记，以指导诊断检查的时间和程度。
Embolism from a proximal source to the retinal circulation could be a sign of embolism from the same source to the hemispheric circulation. We sought to determine the frequency of acute brain infarcts on diffusion-weighted imaging (DWI) in patients with monocular visual loss of presumed ischemic origin (MVL). We retrospectively studied 129 consecutive patients with MVL secondary to retinal ischemia. All patients underwent DWI, comprehensive ophthalmologic and neurologic examination, and diagnostic evaluations for the underlying etiology. Statistical analyses explored univariable and multivariable predictors of DWI evidence of acute brain infarcts. DWI revealed concurrent acute brain infarct(s) in 31 of the 129 patients (24%). The probability of positive DWI was higher in embolic versus non-embolic MVL (28% vs. 8%, p=0.04), in MVL characterized by permanent visual loss versus transient symptoms (33% vs. 18%, p=0.04), and in MVL associated with concurrent hemispheric symptoms versus isolated MVL (53% vs. 20%, p<0.01). Patients with positive DWI were more likely to harbor a major underlying etiology as compared to those with normal DWI (OR 3.7, 95% CI 1.5–9.4). This study demonstrates that MVL does not always represent an isolated disease of the retina; approximately one out of every four patients with MVL demonstrates acute brain infarcts on DWI. Since patients with concurrent brain infarcts are more likely to exhibit a cardiac or vascular source of embolism, imaging evidence of brain injury in patients with MVL may be a useful marker to guide the timing and extent of the diagnostic examinations.
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影响因子：
9.9
作者：
Kimberly, W. T.;Gilson, A.;Greenberg, S. M.
通讯作者：
Greenberg, S. M.
影响因子：
8.3
作者：
Ay, Hakan;Benner, Thomas;Sorensen, A. Gregory
通讯作者：
Sorensen, A. Gregory
影响因子：
8.3
作者：
Mead, GE;Lewis, SC;Dennis, MS
通讯作者：
Dennis, MS
影响因子：
4.1
作者：
Perrini, Paolo;Cardia, Andrea;Lanzino, Giuseppe
通讯作者：
Lanzino, Giuseppe
影响因子：
8.3
作者：
Bushi, D;Grad, Y;Tanne, D
通讯作者：
Tanne, D