Basal ganglia damage and impaired visual function in the newborn infant

Abstract

Aim: To examine the effects of early lesions in the visual pathway on visual function; and to identify early prognostic indicators of visual abnormalities.

Methods: The visual function of 37 infants with perinatal brain lesions on magnetic resonance imaging was assessed using behavioural and electrophysiological variables.

Results: Normal visual behaviour was observed in most infants with large bilateral occipital lesions, but all the infants with associated basal ganglia involvement had abnormal visual function. Visual abnormalities were also present in six infants with isolated basal ganglia lesions.

Conclusions: These observations suggest that basal ganglia may have an integral role in human visual development and that their presence on neonatal MRI could be an early marker of abnormal visual function.

Figure 1

Boy aged 2 weeks. T1 weighted spin-echo sequence [TE 860/20] showing, bilateral abnormal signal intensity in the posterior aspects of the putamen and thalamus. This child had multiple abnormalities on both the visual assessments performed at 3 and 6 months.

Figure 2

Correlation between MRI and visual findings: *generalised cortical lesions involving occipital cortex; ocul mov ocular movement; OKN optokinetic nystagmus; fix'n shift fixation shift; att dist attention at distance.

Figure 3

Boy aged 2 weeks. T1 weighted spin-echo sequence [TE 860/20], showing bilateral haemorrhagic lesions involving the occipital pole and additional haemorrhagic involvement of both temporal lobes. There are no abnormal signal intensities in the basal ganglia and talami. This child tested normal on all the visual tests used.