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首页> 外文期刊>Turk Neuroloji Dergisi >Balint Syndrome due to Bilateral Parieto-occipital Ischemic Stroke
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Balint Syndrome due to Bilateral Parieto-occipital Ischemic Stroke

机译：双侧顶枕缺血性卒中所致的Balint综合征

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A 50-year-old male was evaluated in our neurology clinic during a follow-up visit due to previous ischemic stroke. An interrogation of his medical history revealed that the patient had been under follow-up due to rheumatic heart disease and related aortic valve insufficiency since childhood. Due to the progression of ventricular dysfunction, a prosthestic aortic valve replacement was performed nine years ago. After this surgery, when the influence of anesthesia was over, a significant weakness in his left upper extremity was noticed. More devastatingly, he was unable to visually perceive any colored or colorless objects. However, the symptoms improved in the following one-year period and the patient was able to perceive the objects, separately. At admission to our clinic, his direct and indirect pupillary light reflexes were evaluated as normal. In addition, the visual acuity was found to be bilaterally normal. However, the patient was unable to make pursuit eye movements, as well as saccadic eye movements, which were totally absent in the left direction and moderately disturbed in right direction. Moreover, during the oculocephalic test, rotation of the eyes to the opposite direction of the head movements were observed. Ability of visual-guided reaching was defective. This was compatible with optic ataxia. In addition, the patient was able to see and read a letter but could not combine the letters to perceive a word, which was compatible with simultanagnosia. The patient could distinguish the objects separately; however, he had difficulty when they were visualized side-by-side or back-to-back (Video 1). Cranial tomography showed bilateral parietooccipital hypodensity, which was prominent in the left hemisphere (Figure 1). The clinical findings of severe oculomotor apraxia, optic ataxia, and simultanagnosia led to the diagnosis of Balint syndrome due to ischemic stroke.
机译：由于先前的缺血性卒中，在随访期间在我们的神经病学诊所对一名50岁男性进行了评估。对他的病史的询问显示，该患者自童年以来就因风湿性心脏病和相关的主动脉瓣关闭不全而接受了随访。由于心室功能障碍的进展，九年前进行了人工主动脉瓣置换术。手术后，当麻醉作用结束时，发现左上肢明显无力。更具有破坏性的是，他无法从视觉上感知任何有色或无色的物体。但是，在接下来的一年中症状有所改善，并且患者能够分别感知到物体。在进入我们的诊所时，他的直接和间接瞳孔光反射被评估为正常。另外，发现视力是双侧正常的。但是，患者无法进行追踪眼球运动和扫视眼球运动，这些运动在左方向上完全不存在，而在右方向上则受到中度干扰。此外，在眼动眼测试中，观察到眼睛向与头部运动相反的方向旋转。视觉引导到达的能力存在缺陷。这与视觉共济失调兼容。另外，患者能够看到和阅读字母，但是不能将字母组合来感知单词，这与同时诊断相符。患者可以分别区分对象;但是，当它们并排或背对背可视化时，他有困难（视频1）。颅骨断层扫描显示双侧顶枕低密度，在左半球突出（图1）。严重的动眼性运动失用，视神经共济失调和同时诊断的临床发现导致缺血性中风引起的Balint综合征的诊断。

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