偏盲否认症临床分析

目的探讨偏盲否认症的临床特点、发病机制和大脑半球病变的联系。方法对 1 6例脑梗死所致的同位性视野缺损患者 ,进行视野、智能筛查和详细的偏盲认知、视觉疏忽的神经心理学检查 ,结合MRI或CT的病灶定位进行分析研究。结果 1 6例患者中有 1 0例存在偏盲否认症 ,其中 1 3例右侧脑梗死患者中 8例出现偏盲否认症 ,3例左侧脑梗死患者中 2例出现偏盲否认症 ;6例非偏盲否认症患者中 3例存在偏侧视觉忽视。 1 0例偏盲否认症中 ,7例为大脑中动脉供血区较大面积梗死 ,3例为枕叶或颞枕交界处小灶梗死。结论视觉认知过程在大脑皮层中没有固定的特殊区域 ,其通过多个皮层及皮层下结构协同完成 ;双侧大脑半球均与视觉认知过程有关

Hemianopic anosognosia:Clinical analysis of 16 cases

ObjectiveTo investigate the clinical features, mechanism and cerebral functional correlation of hemianopic anosognosia.Methods16 patients with homonymous visual field defects due to ischemic infarcts were examined on visual field and MMSE. The neuropsychological tests were administered such as hemianopic awareness and visual neglect. The facts were analyzed with the location of ischemic infarct documented by MRI or CT. Results10 of 16 patients with hemianopia had anosognosia of their visual deficit. 8 of 13 right side lesion patients had hemianopic anosognosia. 2 of 3 left side lesion patients had hemianopia anosognosia. 3 of 6 awareness hemianopia patients had visual hemineglect. 7 of 10 hemianopic anosognosia patients had larger infarction of middle cerebral artery. 3 else had smaller infarction in the occipital lobe or in the connective area between the occipital and temporal lobes.ConclusionsThere is no specific cortical area for conscious visual perception. Visual awareness is processed by a distributed network including multiple cortices and subcortices. Both hemispheres are involved in visual processing and conscious awareness.