リハビリ後に回復，代償機能を得た半側空間無視の2例

Two cases of hemispatial neglect was recovered and compensated after rehabilitations

要約　背景：半側空間無視は視覚にかかわる病態であるが，眼科医が診断と治療にあたる機会は少ない。半側空間無視でしばしば検出される同名半盲様視野には，経過中に回復し，代償が生じることがある。

目的：半側空間無視の代償期に同名半盲様視野が回復し，代償機能を得た2症例の報告。

症例：1例は77歳男性で，右側頭葉から頭頂葉にかけて脳出血が生じた。他の1例は78歳女性で，右後頭葉に脳出血が生じた。

所見と経過：両症例とも線分二等分試験と時計描写試験は半側空間無視のパターンを呈し，左右眼に類似性がない同名半盲が検出された。いずれも2か月後に正常化した。

結論：半側空間無視は，慢性期に入っても改善することがある。左側の同名半盲が回復傾向を示す症例の中には，後頭葉視覚野の障害による典型的な同名半盲ではなく，半側空間無視によるものが混在している可能性がある。

Abstract　Background: Visual field defect simulating homonymous hemianopia is often present in patients with hemispatial neglect. This visual field may be compensated in the clinical course.

Purpose: To report 2 cases of hemispatial neglect who showed recovery and compensation of visual field defect simulating homonymous hemianopia.

Cases: One was a 77-year-old male who developed cerebral hemorrhage in the right temporal lobe. The other was a 78-year-old female who developed cerebral hemorrhage in the right occipital lobe.

Findings: Both cases showed findings typical for hemispatial neglect by line bisection task and clock drawing test. Poor uniformity in hemianoptic visual field was also present between the right and left eye. All the clinical manifestations became normal after 2 months of onset in both cases.

Conclusion: The present cases show that hemispatial neglect may recover or be compensated even in the chronic phase. There is the possibility that hemispatial neglect is the underlying lesion whenever homonymous hemianopia, particularly left-sided one, shows recovery in the chronic phase.