Development of the visual pathway: optic chiasm.
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Three cases of damage to the optic nerves and chiasma following pituitary irradiation with Co60 teletherapy are described. All of them presented with progressive visual impairment months following irradiation and simulated recurrence of the tumour. CT scan was also not helpful in differentiating radionecrosis from tumour recurrence. On exploration the optic nerves and chiasma appeared discoloured and scarred. One case, who also had diffuse radionecrosis of brain parenchyma, died. No satisfactory therapy is currently available for this grave complication but proper safeguards can prevent it.
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The density and pattern of distribution of 5-HT1 receptor sites was examined using quantitative in vitro autoradiography with [3H]5-HT as a ligand in the visual structures of 5 weeks old kittens. One group of animals had normal binocular vision, the other was monocularly deprived during the last three days of life. The density of 5-HT1 receptor sites and the pattern of their distribution in the visual structures showed distinct regional, areal and laminar differences. In the primary visual cortex (area 17) a high labelling density was found as compared with other cortical areas investigated. Three bands of high binding density were observed corresponding to cortical layers II-III, IV c and VI. This pattern distinguished area 17 from other cortical areas investigated. In subcortical visual structures very high labelling was present in the superficial visual layers of superior colliculus, but LGN showed rather weak labelling although the lamination of LGN was also seen in the pattern of distribution of 5-HT1 sites. Neither density nor pattern of 5-HT1 sites in the visual cortex and superior colliculus were affected by 3 days of monocular deprivation. High density of labelling and the distinct pattern of 5-HT1 receptor sites in the primary visual cortex suggest the important role of serotonergic transmission in the modulation of visual afferent input activity.
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Single cell experiments in primates show that there are two major parallel pathways named after the lamination in the lateral geniculate nucleus. Each of these systems can be preferentially excited by appropriate stimuli. Here we report that in man the polarity of the evoked potentials both in retina and in cortex depends on which of these pathways is stimulated. The identification of the resulting waveforms is thereby simplified--a matter of practical importance. The fact that at retina and cortex there are characteristic potentials may reflect the different cell biology of the two pathways.
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Marked arteriovenous malformation in the left parietooccipital area manifested only by symptoms of associative migraine involving changes of visual fields indicative of impaired functions of symmetrical compartments of the other brain hemisphere. Visual evoked potentials were changed in this patient because of dysfunction of both hemispheres and largely because of disorders in brain structures symmetrical to the site of arteriovenous malformation. This can be regarded as a manifestation of the so-called stealing phenomenon, when blood supply to one brain compartment is decreased because of excessive blood delivery to other regions of the brain. The results permit us to hypothesize regulation of blood supply to symmetrical compartments of brain hemispheres.
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