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https://doi.org/10.5671/ca.45.2.4

Visual Deficiency in Wallenberg’s Syndrome

Mirjana Bjeloš ; Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Zagreb, Croatia
Ana Križanović
Mladen Bušić ; Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Zagreb, Croatia
Biljana Kuzmanović Elabjer ; Department of Ophthalmology, Reference Centre for Paediatric Ophthalmology and Strabismus of the Ministry of Health of the Republic of Croatia, Sveti Duh University Hospital, Zagreb, Croatia


Puni tekst: engleski pdf 209 Kb

str. 157-159

preuzimanja: 139

citiraj


Sažetak

The aim of this case report of a 47-year-old woman who suffered from acute right-sided medullar ischemic stroke was to define the range of visual impairment in Wallenberg’s syndrome (WS). The patient complained of unbearable environmental tilt and rotating visual perception. On examination, 11 months following the stroke, the patientm anifested rightsided postural inclination and gaze ipsipulsion. The fixation in primary position was unstable, after a conjugate ipsipulsion ensued, spontaneous corrective saccades and a horizontal-rotational jerking nystagmus beating away from the side of the lesion were generated. Monocular visual acuity (right eye: 0.4 logMAR distance and 0.2 logMAR near; left eye: 0.1 logMAR distance and 0.0 logMAR near) was significantly better than binocular (0.63 logMAR distance and near). Fluent reading was impossible. Contralateral smooth pursuits were more impaired. Saccades were defective manifesting right hypermetria and left hypometria. Visual field was constricted to central 10 – 20°. A diagnosis of Wallenberg’s syndrome was made. Occlusion was prescribed. Review of literature demonstrated lack of evidence-based guidelines for ophthalmic assessment and treatment of visual impairment in WS. Oculomotor abnormalities, oscillopsia and tilt illusion cause significant impact to daily life. Early post-stroke ophthalmological evaluation is thus mandatory in order to offer timing treatment.

Ključne riječi

lateral medullary syndrome, ischemic stroke, vision, nystagmus, saccades

Hrčak ID:

266683

URI

https://hrcak.srce.hr/266683

Posjeta: 378 *