Cases reported "Hemianopsia"

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1/96. Cerebral metastasis presenting with altitudinal field defect.

    A 75-year-old man presented with a unilateral inferior altitudinal visual field defect and a history of weight loss and night sweats. The acuity in the affected eye was 20/200, otherwise his ocular examination was normal. neuroimaging demonstrated a post-fixed chiasm, with a frontal metastasis compressing the intracerebral portion of the optic nerve. A chest x-ray showed classical cannon ball lesions, secondary to malignant melanoma. This is the first case report of an intracerebral tumor producing an inferior altitudinal field defect.
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keywords = optic
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2/96. Palinopsia with bacterial brain abscess and noonan syndrome.

    Though positive visual symptoms can be psychological in nature, or can result from a perceptive or anxious patients recognizing optical principals in the eye itself, this case illustrates how a thorough history is required to delineate those rarer signs which accompany serious macular or neuro-ophthalmic pathology.
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keywords = optic
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3/96. Retinal red-free light photographs in two congenital conditions: a case of optic hypoplasia and a case of congenital hemianopia.

    Two patients with congenital anomalies involving the optic pathways are described. The first case presented a unilateral hypoplastic optic nerve as well as an ipsilateral inferior conus and an elevated disc. The second case showed the features of homonymous hemianopia with sparing of the macula and decreased visual acuity on the side of the affected cerebral hemisphere. Red-free photographs were obtained in both cases. The importance of this old-new investigative tool in completing a neuro-ophthalmological study is stressed.
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ranking = 6
keywords = optic
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4/96. Visual loss in a 42-year-old man.

    A 42-year-old man developed blurred vision and was found to have a right, incongruous, inferior homonymous quadrantanopia. neuroimaging disclosed a suprasellar mass. The mass was thought to be a pituitary adenoma that was compressing the left optic tract, and transsphenoidal surgery was planned; however, because the defect was primarily inferior, indicating damage to the superior aspect of the optic tract, it was recommended that a craniotomy be performed. The mass was found at surgery to be a craniopharyngioma.
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ranking = 2
keywords = optic
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5/96. Non-ruptured large dorsal internal carotid artery aneurysm presenting with temporal quadrantanopsia.

    A 63-year-old woman presenting with temporal lower quadrantanopsia of the right eye was found to have a large dorsal internal carotid artery aneurysm. Large dorsal aneurysms of the internal carotid artery are rare. Lateral compression of the optic nerve by the aneurysm might damage the optic nerve at the medial side of the right optic foramen. Direct clipping surgery was performed uneventfully. Since the dome of the aneurysm was buried in the frontal lobe and also attached to the anterior skull base, a careful approach to the aneurysm with removal of the anterior clinoid process and drilling into the planum sphenoidale around the aneurysm dome was needed. The surgical strategy is discussed.
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ranking = 3
keywords = optic
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6/96. Bilateral occipital lobe stroke with inferior altitudinal defects.

    BACKGROUND: Cerebrovascular disease is the most common cause of neurological disability in Western countries. patients who survive cerebrovascular accidents exclusive to the occipital lobe often have no significant neurological deficits other than visual-field loss. Visual-field defects from occipital lobe stroke typically include congruous homonymous hemianopsias or quadranopsias, with or without macular sparing. CASE REPORT: A 61-year-old white man came to us with symptoms of sudden loss of vision and difficulty reading. Visual-field testing revealed a bilateral inferior altitudinal defect with normal optic nerve and fundus appearance in both eyes. On radiological examination, he was found to have had a bioccipital lobe cerebrovascular accident secondary to complete occlusion of the left vertebral artery. An embolic event causing the artery occlusion, in combination with bilaterally compromised cerebellar and posterior cerebral arteries, presumably caused the bilateral stroke. After appropriate medical and neurological consultation, optometric management consisted of maximizing the patient's remaining vision with a prismatic spectacle correction. DISCUSSION/CONCLUSION: patients with infarction exclusive to the occipital lobe typically have no other neurological deficits except visual-field loss and are often easier to manage than patients with infarctions to other areas of the cerebral cortex or multiple infarctions. Visual-field loss from occipital lobe damage can be successfully managed with optical systems and/or visual rehabilitation. Factors related to management include location and extent of visual-field damage, functional visual needs, and both personal and health concerns of the patient. A discussion is presented on cerebrovascular disease, occipital lobe infarction, imaging techniques, and visual rehabilitation.
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ranking = 2
keywords = optic
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7/96. Optic tract compression from dolichoectatic basilar artery.

    PURPOSE: To report a case of optic tract compression caused by a dolichoectatic basilar artery. DESIGN: Observational case report. methods: A 74-year-old man with progressive loss of vision over 13 years and no other neurologic signs or symptoms was found to have bilateral optic nerve head pallor and a left homonymous hemianopia. RESULTS: magnetic resonance imaging and angiography revealed a severe dolichoectatic basilar artery compressing the right optic tract. CONCLUSION: basilar artery dolichoectasia may rarely cause compression of the optic tract and progressive visual loss.
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ranking = 4
keywords = optic
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8/96. Peripheral homonymous scotomas from a cavernous angioma affecting fibers subserving the intermediate region of the striate cortex.

    PURPOSE: To report the case of a pure peripheral homonymous visual field defect and to delineate the representation of the visual field on the striate cortex. methods: Observational case report. Neuro-ophthalmologic and neuroimaging assessment of a patient with a cavernous angioma of the right parieto-occipital lobe. RESULTS: The patient had left homonymous scotomas located 40 degrees to 60 degrees from the vertical meridian. neuroimaging indicated that the lesion was affecting the optic radiations at their termination in the intermediate portion of the striate cortex or the striate cortex itself. CONCLUSION: Homonymous field defects are typically located within 10 degrees of fixation. This patient had a peripheral homonymous field defect from damage to the intermediate striate cortex. Correlation of the neuroimaging findings in this case with the most commonly used maps of the representation of the visual field on the striate cortex suggests that none of the maps correctly predicts the location or extent of lesions that affect the intermediate portion of the cortex.
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ranking = 1
keywords = optic
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9/96. Prism adaptation improves chronic visual and haptic neglect: a single case study.

    Visuomotor adaptation to rightward displacing optical prisms is known to induce temporary improvements in the symptoms of left visual neglect. We report a 74 year-old woman with severe and chronic neglect of nine months duration, who underwent three weekly sessions of prism adaptation. Substantial improvements were obtained on tests of visual neglect (cancellation, copying and bisection). Improvement was also observed on a spatial judgement task, with no explicit visual component, in which CS was required to locate the centre of a haptically explored circle. These observations confirm that brief periods of prism exposure can benefit even chronic neglect disorders. Moreover, the improvement observed on the haptic task supports the belief that this procedure can influence higher levels of spatial representation.
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keywords = optic
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10/96. Geniculate hemianopias: incongruous visual defects from partial involvement of the lateral geniculate nucleus.

    Quantitative perimetric studies in 4 patients with involvement of a lateral geniculate nucleus revealed strikingly incongruous defects in the corresponding homonymous fields of vision. The patterns of these hemianopias are analysed and correlated anatomically with established retinotopic projections on the six cellular laminae of the geniculate nucleus. Incongruous wedge-shaped field defects appear to be pathognomonic of focal disease in the dorsal crest of the geniculate nucleus. Other patterns typify lesions of the medical or lateral horns of the nucleus. On theoretical grounds monocular hemianopic defects should result from unilaminar geniculate lesions, but this perimetric sign awaits confirmation. In each case of geniculate disease where the retinal nerve fibre layer has been examined specifically for efidence of retrograde homonymous atrophy, typical hemiretinal signs were found to be present.
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ranking = 0.019874778485869
keywords = atrophy
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