Article

Cortical blindness is a rare complication of posterior circulation
stroke. However, its complex presentation with sensory, physical, cognitive and
behavioural impairments makes it one of the most challenging. Appropriate
approach from a rehabilitation standpoint was never reported.
Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness.
METHOD: The notes of all patients with cortical blindness
referred to a local NHS rehabilitation service in the last 6~years were examined.
Patients' demographics, presenting symptoms, scan findings, rehabilitation
programmes and outcomes were documented. RESULTS: Seven patients presented to our
service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had
total blindness with severe cognitive and behavioural impairments, wandering and
akathisia. All of them failed to respond to any rehabilitation effort and the
focus was on damage limitation. Pharmacological interventions had a modest impact
on behaviour and sleep pattern. The 3 patients were discharged to a nursing
facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity.
All of them suffered from significant memory impairment. However, none suffered
from any behavioural, physical or other cognitive impairment. Rehabilitation
efforts on 3 patients were carried out collaboratively between brain injury
occupational therapists and sensory disability officers. All patients experienced
significant improvement in handicap and they all maintained community placements.
CONCLUSION: This small cohort of patients suggests that the rehabilitation
philosophy and outcomes of these 2 distinct groups of either total or partial
cortical blindness differ significantly.

Langue : ANGLAIS