Homonymous hemianopia - case report

  • Alenka Lavrič
  • Viktor Švigelj
  • Borut Prestor
  • Marko Hawlina
Keywords: homonymous hemianopia, carotid-ophthalmic artery aneurysms, retrochiasmal lesions of the visual pathways

Abstract

Background: Homonymous hemianopia is a temporal visual hemifield loss of one eye and nasal visual hemifield loss of another eye. It is caused by optic tract or radiations lesions. Incongruous defects are characteristic for optic tract and congruous visual field defects are appearing in optic radiations and occipital cortex lesions. Etiologically, homonymous defects are usually vascular in origin, however they could appear in brain tumours, central nervous system infections, traumatic brain lesions and migraine.

Case report: We present a clinical picture, diagnostic procedures and course of events in 54 years old patient who was examined Eye Clinic at Clinical Centre, because of homonymous visual field defect. The cause of homonymous hemianopia in patient were the intracranial aneurysms. The article, from ophthalmologic point of view, discusses symptoms and signs of aneurysms, diagnostic considerations and possible complications.

Conclusions: Incongruous homonymous hemianopia is an ophthalmologic emergency and is characteristic of optic tract lesions, between which are also aneurysms of the carotid system, especially carotid-ophthalmic artery aneurysms. Recognition, prompt diagnostic consideration and treatment action are crucial in prevention of life-threatening complication as rupture of aneurysm and consecutive subarachnoid haemorrhage is.

Downloads

Download data is not yet available.

References

Pietsch P. Hemianopsia and neuroanatomy. Dosegljivo na: http://www.indiana.edu/~pietsch/hemianopsia.html

Kanski JJ. Clinical ophthalmology. A systematic approach. Fifth ed. Oxford: Butterworth-Heinemann; 2003.

Walsh JT. Visual fields: examination and interpretation. Second edition. San Francisco: American Academy of Ophthalmology, Place Press; 1997.

American Academy of Ophthalmology. Basic and clinical science course. Neuro-ophthalmology. Am Acad Ophthalmol 2003– 2004: 105–22.

Zhang X, Kedar S, Lynn MJ, Newman NJ, Biousse V. Homonymous hemianopias: clinical-anatomic correlations in 904 cases. Neurology 2006; 66: 906–10.

Brazis PW, Lee AG, Graff-Radford N, Desai NP, Eggenberger ER. Homonymous visual field defects in patients without corresponding structural lesions on neuroimaging. J Neuroophthalmol 2000; 20: 92–6.

Savino PJ, Paris M, Schatz NJ, Orr LS, Corbett JJ. Optic tract syndrome: a review of 21 patients. Arch Ophthalmol 1978; 96: 656–63.

Verweij RD, Eijdicks EFM, van Gijn J. Warning headache in aneurismal subarachnoid hemorrhage: A case-control study. Arch Neurol 1988; 45: 9–20.

Vega C, Kwoon JV, Lavine SD. Intracranial aneurysms: Current evidence and clinical practice. American Family Physician Avg 2002. Dosegljivo na: http://www.aafp.org/afp/20020815/601.html

Raps EC, Rogers JD, Galetta SL, Solomon RA, Lennihan L, Klebanoff LM, et al. The clinical spectrum of unruptured intracranial aneurysms. Arch Neurol 1993; 50: 265–8.

Hahn CD, Nicolle DA, Lownie SP, Drake CG. Giant cavernous carotid aneurysms: clinical presentation in fifty-seven cases. J Neuroophthalmol 2000; 20: 253–8.

Kasner SE, Liu GT, Galetta SL. Neuro-ophthalmologic aspects of aneurysms. Neuroimaging Clin N Am 1997; 7: 679–92.

Unruptured intracranial aneurysms – risk of rupture and risks of surgical intervention. International study of Unruptured Intracranial Aneurysms Investigators. N Engl J Med 1998; 339: 1725–33.

Okawara SH. Warning signs prior to rupture of an intracranial aneurysm. J Neurosurg 1973; 38: 575–80.

White PM, Teasdale EM, Wardlaw JM, Easton V. Intracranial aneurysms: CT angiography and MR angiography for detection – Prospective blinded comparison in a large patient cohort. Radiology 2001; 219: 739–49.

Hesselink JR. Subarachnoid haemorrhage and intracranial aneurysms. Dosegljivo na: http://spinwarp.ucsd.edu/NeuroWeb/Text/br-730.htm

How to Cite
1.
Lavrič A, Švigelj V, Prestor B, Hawlina M. Homonymous hemianopia - case report. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];76(3). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1664
Section
Case report