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VISUAL FIELD DEFECTS IN HYDROCEPHALUS Noriaki Kojima 1 , Norihiko Tamaki 1 , Kohkichi Hosoda 1 , Satoshi Matsumoto 1 1Department of Neurosurgery, Kobe University School of Medicine pp.229-236
Published Date 1985/3/1
DOI https://doi.org/10.11477/mf.1406205472
  • Abstract
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Eight patients representing visual field defects associated with hydrocephalus are reviewed. Seven cases had aqueductal stenosis and one had con-genital communicating hydrocephalus.

We found five cases of defects in visual field typical of a chiasmal or optic nerve lesion :(1) inferior altitudinal hemianopia with inferior nasal quadrantanopia in the opposite eye;(2) inferiorbinasal quadrantanopia;(3) unilateral inferior nasal depression;(4) unilateral temporal defect ;(5) bilateral central scotoma. In these cases CTdemonstrated moderate or marked symmetrical dilatation of the third and lateral ventricles. Four out of five cases showed buldging of the third ventricle anteriorly into the sella turcica on CTor ventriculography.

Other three patients had incongruous homony-mous hemianopia. Characteristic asymmetrical dilatation of the lateral ventricles was noted in all three cases. The more enlarged lateral ventricles were ipsilateral with the affected visual pathways. The sites of lesion responsible for these field defects seemed to be optic tract in one case and optic radiation in two cases.

Ventriculoperitoneal shunt was placed in five out of seven cases. Impaired visual field improved in three patients after shunt insertion. A 28-year-old female who had had history of blurred vision fos 14 days showed improvement in visual acuity and field when the enlarged ventricles became slit-like by shunting. In the other two patients defects in visual fields improved in spite of consistent ventriculomegaly. These facts suggested that not only the mechanical forces with distended third ventricle but also increased intracranial pressure played an important role in producing visual field defects in hydrocephalic patients.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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