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Hiazmalny syndrome


The defeat of a hiazma which is shown primary atrophy of optic nerves and a bitemporal hemianopsia.

Symptoms of the Hiazmalny syndrome:

The clinical picture is various. Distinguish a typical and atypical form of a disease. At a typical hiazmalny syndrome in an early stage small decrease in visual acuity on both eyes is noted, the eyeground can be normal or only easy blanching of disks of optic nerves is planned. At careful and systematic perimetry restriction of a field of vision in verkhnenaruzhny quadrants, absolute or relative gemianopsichesky scotomas are found. In this stage of complaints to deterioration in sight can not be. In the developed stage of a disease primary atrophy of optic nerves and a bitemporal hemianopsia are observed. Visual acuity is usually lowered. In a late stage visual acuity is sharply lowered, the field of vision is kept from the inside in the form of narrow sites, the expressed atrophy of optic nerves is noted. The full amaurosis on one or on both eyes is quite often observed.

The atypical form of a hiazmalny syndrome meets quite often. In an early stage visual acuity goes down on one eye, usually at a picture of retrobulbar neuritis. There are no characteristic defects under review. The atrophy of an optic nerve develops later. In several months (or years) visual acuity of the second eye begins to go down that indicates transition of a disease to the developed stage. At the same time in sight of the best eye characteristic losses often come to light (restriction in a verkhnenaruzhny quadrant, a temporal hemiahromatopsia, etc.). A final stage of process same, as at a typical hiazmalny syndrome.

The atypical hiazmalny syndrome sometimes develops at the same time on both eyes. Visual acuity goes down without emergence of characteristic defects under review. The central scotomas or losses of a field of vision of a various form can be observed. The congestive optic disk at defeat of a hiazma is observed seldom. It proceeds as the complicated congestive disk and demonstrates secondary defeat of a hiazma.

Reasons of the Hiazmalny syndrome:

The etiology is diverse: tumors of a hypophysis and brain, meningitis, hiazmalny arachnoiditis, multiple sclerosis, brain cysticercus, injury of a skull, intoxication, etc.

Pathogeny. The major factor leading to development of a disease is the hiazma prelum. Pathological changes in a hiazma arise not only in the place of its prelum, but also in the sites remote from it that is connected with hiazma shift. Depending on defeat of the nerve fibrils passing in a hiazma various symptoms of a disease develop. At meningitis inflammatory process from a meninx can extend to a hiazma. Toxic influences sometimes lead to degenerative processes in a hiazma.

The hiazma prelum, inflammatory and degenerative processes in it usually lead to an atrophy of nerve fibrils.

Treatment of the Hiazmalny syndrome:

First of all treatment of a basic disease. At brain tumors — an oncotomy or a roentgenotherapy. In case of a hiazmalny arachnoiditis — antibiotics of a broad spectrum of activity, intravenous injections of glucose, hexamethylenetetramine, vitamins, a surgical adhesiotomy in hiazmalny area. Aneurism of front departments of an arterial circle of a great brain is exposed to neurosurgical or conservative treatment.
The forecast is always serious. The nature of defeat of a hiazma, timely recognition and the correct treatment matter.

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