Open AccessVisual Deficiency in Wallenberg’s Syndrome
Author(s) -
Mirjana Bjeloš,
Ana Križanović,
Mladen Bušić,
Biljana Kuzmanović Elabjer
Publication year - 2021
Publication title -
collegium antropologicum
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.138
H-Index - 42
eISSN - 1848-9486
pISSN - 0350-6134
DOI - 10.5671/ca.45.2.4
Subject(s) - medicine , visual acuity , oscillopsia , monocular , gaze , nystagmus , binocular vision , stroke (engine) , visual impairment , hemianopsia , audiology , ophthalmology , psychology , visual field , mechanical engineering , artificial intelligence , psychiatry , computer science , psychoanalysis , engineering
The aim of this case report of a 47-year-old woman who suffered fromacute right-sided medullar ischemic stroke was to define the range of visualimpairment in Wallenberg’s syndrome (WS). The patient complained of unbearableenvironmental tilt and rotating visual perception. On examination, 11 monthsfollowing the stroke, the patient manifested rightsided postural inclinationand gaze ipsipulsion. The fixation in primary position was unstable, after aconjugate ipsipulsion ensued, spontaneous corrective saccades and ahorizontal-rotational jerking nystagmus beating away from the side of thelesion were generated. Monocular visual acuity (right eye: 0.4 logMAR distanceand 0.2 logMAR near; left eye: 0.1 logMAR distance and 0.0 logMAR near) wassignificantly better than binocular (0.63 logMAR distance and near). Fluent readingwas impossible. Contralateral smooth pursuits were more impaired. Saccades weredefective manifesting right hypermetria and left hypometria. Visual field wasconstricted to central 10 – 20°. A diagnosis of Wallenberg’s syndrome was made.Occlusion was prescribed. Review of literature demonstrated lack ofevidence-based guidelines for ophthalmic assessment and treatment of visualimpairment in WS. Oculomotor abnormalities, oscillopsia and tilt illusion causesignificant impact to daily life. Early post-stroke ophthalmological evaluationis thus mandatory in order to offer timing treatment.