35 year old with gradually progressive left homonymous hemianopia.

Usually white matter pathologies are hyperintense on T2 and FLAIR.

But when is white matter hypointense on T2 and FLAIR, isointense on T1, without diffusion restriction or post contrast enhancement?

🧵

Anterior choroidal Artery stroke- triad of hemiparesis + hemianaesthesia + hemianopia. Movement disorders include new-onset parkinsonism, choreoathetosis or posterior variant of alien limb syndrome. This lady developed unilateral Rt sided parkinsonism 2 weeks after AchA stroke

Yes I’m gonna die without ever being able to say “homonymous hemianopia” properly but I finally didn’t get destroyed by a stroke syndrome block???? 🥹

THE CIRCLE OF WILLIS (might) NOT DEFEAT ME

Not seeing or hearing a truck approaching is a huge thing that mostly psychological stress related global inattention but neurologically
1-Its very unlikely that he has
subcortical right hemonomous
hemianopia because he is
moving his right arm and leg👇

68 m px with anosmia, temp hemianopia & bilat visual acuity impairment.

Olfactory groove meningioma.

#skullbase #nsgy

#Ophthalmology

In case of bitemporal hemianopia, where will be the lesion the optic tract?
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#MedTwitter #MedX #MedEd

Charles Bonnet Syndrome

Visual hellucinations in area of visual field or visual acuity loss
caused by spontaneous activation of visual cortex

This pt having hellucinations in Left congruent homonymous hemianopia area after R PCA stroke

Pt described seeing white floaters
No visual field cut appreciated on exam

So the best possible guess was
Scotoma as Paracentral L homonymous hemianopia that was
too small to be picked up on confrontation method

MRI showed right PCA stroke

A patient of mine was recently diagnosed with a brain tumour.
It is a pituitary macroadenoma &has caused a Bitemporal hemianopia (loss of vision in half of both eyes). I made the initial tentative diagnosis, & MRI shows it encases d carotid arteries bilaterally. Here's her story

All I see is types of hemianopia! xD

Discover the power of precision with Jutron Vision's high-quality Prism Set that measures the deviation in strabismus like crossed eyes and non-strabismus conditions like convergence insufficiency, nystagmus, hemianopia, etc.

A busy day at the Joint Library of Ophthalmology, Moorfields and UCL UCL Institute of Ophthalmology finding papers from the 1920’s - some of the first descriptions of glasses for hemianopia

It's the #LensQOTW 👁‍🗨
39F was referred from ED with sudden onset bitemporal hemianopia, forgetfulness, and decreased hearing.
PMH: typical migraines, no Ocular Hx.
CSF: unspecific elevated total protein.
What is the most likely diagnosis?
VOTE ⬇️
#Ophthalmology #retina

I was reminded today of this incredible drawing that a person with hemianopia made during their stay on the stroke unit. Their Charles Bonnet syndrome visions got worse when the ward was busier, and often consisted of people dressed in very elaborate clothes

Mrs K is 100% blind on right or right hemianopia and from fatigue and has other coordination issues.

I miss being able to do some bush walks or hikes. It's limited to flat, low-risk walks.

I'm finding more and more she is slipping. Feel guilty doing things by myself. Bit sad.

Stroke neurologist tip if the day: Thalamic strokes can mimic cortical strokes.
Anterior - Aphasia& Amnesia
Posterior- Peripheral vision ( hemianopia )
Lateral - Limb sensor motor
Medial- Memory and level of consciousness

Visual field defects after anterior temporal lobectomy: how can we localize and visualize the damage using differential tractography?

Here are examples of a patient with hemianopia and another with quadrantanopia after ATL:

youtube.com/watch?v=zYXUAS…

Distal P2 MT, disabling Rt hemianopia in a 60yo policeman, 2 passes aspiration with 3MAX-RED 68 at face of clot. Vision improved on table. Pulled out a gummy bear clot, would not have self-recanalized.
Are others routinely taking these distal PCAs in light of #PLATO . Visish M. Srinivasan, MD

A fun afternoon teaching Great Ormond Street Hospital Eye Department about how we use pattern VEPs to look for evidence of Homonymous hemianopia in children. Read more in our open access review in Eye Journal nature.com/articles/s4143…

If the lesion occurs after the optic chiasm, then fibers from both CNIIs are damaged, and one visual field in both eyes (on the opposite side of the lesion) is lost (hemianopia). The opposite field is preserved because of those crossing fibers!