Anatomy of optic nerve radiations as assessed by static perimetry and MRI after tailored temporal lobectomy
Anatomy of optic nerve radiations as assessed by static perimetry and MRI after tailored temporal lobectomy
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DOI：
10.1136/bjo.84.8.884
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发表时间：
2000-08-01
影响因子：
4.1
通讯作者：
Vighetto, A
中科院分区：
文献类型：
--
作者：
Krolak-Salmon, P;Guenot, M;Vighetto, A
目的，以确定视神经辐射在颞叶，特别是他们的retinotopic组织和前极限的Meyer's loop.Methods-18成人患者接受了定制的颞叶切除术癫痫的过程中，包括在本研究1994年和1998年之间。侧颞叶切除术中由外科医生和术后MRI进行评估的rostrocaudal程度进行了比较，术后视野确定的自动静态视野检查（ASP）。结果-15例（83%）提出了一个术后视野缺损（VFD）局限于上级homedarfield对侧切除。观察到从最小上视野损失到完全象限盲的所有程度。VFD有些定型，主要沿垂直子午线沿着分布。导致VFD的最小前后位切除限制在距颞叶尖端20 mm处。观察到第二和第三回旋前方外侧切除的范围与术后VFD的发生和范围之间的关系。没有病人报告持续的主观vision impaire. Conclusion术后VFD的高频率似乎是由于ASP的更大的敏感性。刻板的VFD的特点允许新的结论视神经辐射的过程和retinotopy。Meyer氏袢的前界可能比以前认为的更靠近嘴侧。
Aims-To determine the course of optic nerve radiations in the temporal lobe, especially their retinotopic organisation and the anterior Limit of the Meyer's loop.Methods-18 adult patients who had undergone a tailored temporal lobectomy for epilepsy were included in this study between 1994 and 1998. The rostrocaudal extent of the lateral temporal lobe resection assessed intraoperatively by the surgeon and by postoperative MRI was compared with the postoperative visual fields determined by automated static perimetry (ASP).Results-15 patients (83%) presented a postoperative visual field deficit (VFD) confined to the superior homonymous field contralateral to the side of the resection. All degrees from a minimal upper field loss to a complete quadrantanopia were observed. The VFDs were somewhat stereotyped, predominating along the vertical meridian. The smallest anteroposterior resection resulting in a VFD was limited to 20 mm from the tip of the temporal lobe. A relation was observed between the extent of the lateral resection in front of the second and third convolutions and the occurrence and extent of postoperative VFDs. No patient reported persisting subjective visual impairment.Conclusion-The high frequency of postoperative VFDs appears to be due to the greater sensitivity of ASP. The characteristics of the stereotyped VFDs allow new conclusions about the course and retinotopy of optic nerve radiations. The anterior limit of Meyer's loop is Likely to be located more rostrally than previously believed.