Surgical neurology · 2006
Wilbrand's knee: does it exist?
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lee Joung H, Tobias Samuel, Kwon Jeong-Taik, Sade Burak, Kosmorsky Gregory
Аннотация
OBJECTIVE: In 1904, Hermann Wilbrand reported that nasal ON fibers form a loop into the contralateral ON, subsequently referred to as Wilbrand's knee. He had further theorized that a lesion affecting Wilbrand's knee would develop a distinct visual field defect characterized by an ipsilateral central scotoma with a contralateral superotemporal visual field defect. We present clinical evidence that disputes the existence of Wilbrand's knee.
METHODS: A retrospective analysis of 3 patients whose ONs were divided at the ON-chiasm junction is presented. Two patients had an ONS meningioma and the other patient had sarcoidosis of the ON. Resection of the lesion and the ON up to the nerve-chiasm junction was done to prevent the disease from extending into the OC and the contralateral ON. The patients had detailed neuro-ophthalmologic evaluations preoperatively and postoperatively.
RESULTS: After the resection of the ON at the ON-chiasm junction in the 3 patients, junctional scotoma could not be detected by visual perimetry.
CONCLUSION: No clinical perimetric evidence was found to support the existence of Wilbrand's knee in the anterior visual pathway.
METHODS: A retrospective analysis of 3 patients whose ONs were divided at the ON-chiasm junction is presented. Two patients had an ONS meningioma and the other patient had sarcoidosis of the ON. Resection of the lesion and the ON up to the nerve-chiasm junction was done to prevent the disease from extending into the OC and the contralateral ON. The patients had detailed neuro-ophthalmologic evaluations preoperatively and postoperatively.
RESULTS: After the resection of the ON at the ON-chiasm junction in the 3 patients, junctional scotoma could not be detected by visual perimetry.
CONCLUSION: No clinical perimetric evidence was found to support the existence of Wilbrand's knee in the anterior visual pathway.