Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- PART I CLINICAL MANIFESTATIONS
- 1 Stroke onset and courses
- 2 Clinical types of transient ischemic attacks
- 3 Hemiparesis and other types of motor weakness
- 4 Sensory abnormality
- 5 Cerebellar ataxia
- 6 Headache: stroke symptoms and signs
- 7 Eye movement abnormalities
- 8 Cerebral visual dysfunction
- 9 Visual symptoms (eye)
- 10 Vestibular syndromes and vertigo
- 11 Auditory disorders in stroke
- 12 Abnormal movements
- 13 Seizures and stroke
- 14 Disturbances of consciousness and sleep–wake functions
- 15 Aphasia and stroke
- 16 Agitation and delirium
- 17 Frontal lobe stroke syndromes
- 18 Memory loss
- 19 Neurobehavioural aspects of deep hemisphere stroke
- 20 Right hemisphere syndromes
- 21 Poststroke dementia
- 22 Disorders of mood behaviour
- 23 Agnosias, apraxias and callosal disconnection syndromes
- 24 Muscle, peripheral nerve and autonomic changes
- 25 Dysarthria
- 26 Dysphagia and aspiration syndromes
- 27 Respiratory dysfunction
- 28 Clinical aspects and correlates of stroke recovery
- PART II VASCULAR TOPOGRAPHIC SYNDROMES
- Index
- Plate section
9 - Visual symptoms (eye)
from PART I - CLINICAL MANIFESTATIONS
Published online by Cambridge University Press: 17 May 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- PART I CLINICAL MANIFESTATIONS
- 1 Stroke onset and courses
- 2 Clinical types of transient ischemic attacks
- 3 Hemiparesis and other types of motor weakness
- 4 Sensory abnormality
- 5 Cerebellar ataxia
- 6 Headache: stroke symptoms and signs
- 7 Eye movement abnormalities
- 8 Cerebral visual dysfunction
- 9 Visual symptoms (eye)
- 10 Vestibular syndromes and vertigo
- 11 Auditory disorders in stroke
- 12 Abnormal movements
- 13 Seizures and stroke
- 14 Disturbances of consciousness and sleep–wake functions
- 15 Aphasia and stroke
- 16 Agitation and delirium
- 17 Frontal lobe stroke syndromes
- 18 Memory loss
- 19 Neurobehavioural aspects of deep hemisphere stroke
- 20 Right hemisphere syndromes
- 21 Poststroke dementia
- 22 Disorders of mood behaviour
- 23 Agnosias, apraxias and callosal disconnection syndromes
- 24 Muscle, peripheral nerve and autonomic changes
- 25 Dysarthria
- 26 Dysphagia and aspiration syndromes
- 27 Respiratory dysfunction
- 28 Clinical aspects and correlates of stroke recovery
- PART II VASCULAR TOPOGRAPHIC SYNDROMES
- Index
- Plate section
Summary
Transient monocular blindness
Temporary loss of vision in one eye, termed transient monocular blindness (TMB), is the most important visual symptom of arteriosclerotic vascular disease, arteritis and states of altered coagulability, and thrombocytosis. In most patients, the visual disturbance during each individual attack of TMB is stereotypic. It may recur over a period of months or over a much briefer span of hours, days, or weeks. A meticulous history of the attack and duration of the visual disturbance will permit classification of the TMB occurrence into one of four types. Type I is due to transient retinal ischemia, type II to retinal vascular insufficiency and type III to vasospasm. Type IV occurs in association with antiphospholipid antibodies but includes cases of unknown etiology (Table 9.1 (Wray, 1988; Burde, 1989)).
TMB type I
TMB type I is characterized by a sudden, brief attack of partial or complete dimming or obscuration of vision, lasting seconds to minutes, followed by total recovery. Partial impairment is described as a greyout, or as an ascending or descending curtain or a blind moving sideways across the eye. Occasionally, the patient will describe moving tracks of light. Ipsilateral headache is rare (Wilson et al., 1979). Fisher (1952) drew attention to the association of TMB of this brevity with contralateral hemiplegia. Episodic attacks of fleeting blindness occur as arteriosclerotic plaques progressively narrow the lumen of the ipsilateral internal carotid artery (ICA), leading to periodic reduction in blood flow, reduced pressure in the ophthalmic artery, transient ocular ischemia, or vascular insufficiency.
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- Stroke Syndromes , pp. 111 - 128Publisher: Cambridge University PressPrint publication year: 2001
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