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Summary
Stroke patients with homonymous hemianopia often develop horizontal conjugate gaze paresis, indicating a poor prognosis. This specific gaze issue significantly increases the 30-day fatality risk in stroke survivors.
Area of Science:
- Neurology
- Ophthalmology
- Stroke Medicine
Background:
- Homonymous hemianopia is a common visual field defect following stroke.
- Horizontal conjugate gaze paresis is a neurological sign affecting eye movement control.
Purpose of the Study:
- To investigate the prevalence of horizontal conjugate gaze paresis in stroke patients with homonymous hemianopia.
- To determine the prognostic implications of gaze paresis in this patient population.
Main Methods:
- Prospective and consecutive evaluation of 156 stroke patients.
- Assessment of visual fields for homonymous hemianopia.
- Clinical examination for horizontal conjugate gaze paresis.
Main Results:
- One-third of stroke patients (52/156) presented with homonymous hemianopia.
- Among those with homonymous hemianopia, 46% (24/52) exhibited horizontal conjugate gaze paresis.
- Gaze paresis was more frequent in large hemispheric strokes.
- The 30-day case fatality rate for patients with gaze paresis was 49%, significantly higher than for those without.
Conclusions:
- Horizontal conjugate gaze paresis is a significant clinical finding in stroke patients with homonymous hemianopia.
- The presence of gaze paresis is associated with a poorer prognosis and increased short-term mortality.
- Early identification of gaze paresis may aid in risk stratification for stroke patients.