Profile of Gaze Dysfunction following Cerebrovascular Accident

機(jī)譯：腦血管意外后的注視功能障礙

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Aim. To evaluate the profile of ocular gaze abnormalities occurring following stroke. Methods. Prospective multicentre cohort trial. Standardised referral and investigation protocol including assessment of visual acuity, ocular alignment and motility, visual field, and visual perception. Results. 915 patients recruited: mean age 69.18 years (SD 14.19). 498 patients (54%) were diagnosed with ocular motility abnormalities. 207 patients had gaze abnormalities including impaired gaze holding (46), complete gaze palsy (23), horizontal gaze palsy (16), vertical gaze palsy (17), Parinaud's syndrome (8), INO (20), one and half syndrome (3), saccadic palsy (28), and smooth pursuit palsy (46). These were isolated impairments in 50% of cases and in association with other ocular abnormalities in 50% including impaired convergence, nystagmus, and lid or pupil abnormalities. Areas of brain stroke were frequently the cerebellum, brainstem, and diencephalic areas. Strokes causing gaze dysfunction also involved cortical areas including occipital, parietal, and temporal lobes. Symptoms of diplopia and blurred vision were present in 35%. 37 patients were discharged, 29 referred, and 141 offered review appointments. 107 reviewed patients showed full recovery (4%), partial improvement (66%), and static gaze dysfunction (30%). Conclusions. Gaze dysfunction is common following stroke. Approximately one-third of patients complain of visual symptoms, two thirds show some improvement in ocular motility.

機(jī)譯：目標(biāo)。為了評(píng)估中風(fēng)后發(fā)生的眼睛凝視異常的狀況。方法。前瞻性多中心隊(duì)列研究。標(biāo)準(zhǔn)化的轉(zhuǎn)診和調(diào)查方案，包括視力，眼球排列和運(yùn)動(dòng)性，視野和視覺(jué)感知的評(píng)估。結(jié)果。招募了915名患者：平均年齡69.18歲（SD 14.19）。 498名患者（54％）被診斷為眼球運(yùn)動(dòng)異常。 207例視力異常，包括視力保持障礙（46），完全視力麻痹（23），水平視力麻痹（16），垂直視力麻痹（17），帕里諾氏綜合征（8），INO（20），一分半綜合征（ 3），眼跳性麻痹（28）和順滑性麻痹（46）。這些在50％的病例中是孤立的損傷，在50％的情況下與其他眼部異常有關(guān)，包括會(huì)聚，眼球震顫和眼瞼或瞳孔異常。腦卒中的區(qū)域經(jīng)常是小腦，腦干和雙腦區(qū)域。引起凝視功能障礙的中風(fēng)還涉及皮質(zhì)區(qū)域，包括枕葉，頂葉和顳葉。 35％出現(xiàn)復(fù)視和視力模糊的癥狀。出院37例，轉(zhuǎn)診29例，其中141例接受了復(fù)診。 107例接受檢查的患者表現(xiàn)出完全康復(fù)（4％），部分改善（66％）和靜態(tài)凝視功能障礙（30％）。結(jié)論。注視功能障礙是中風(fēng)后的常見(jiàn)病。大約三分之一的患者抱怨有視覺(jué)癥狀，三分之二的患者眼動(dòng)性有所改善。