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Clinical reasoning: acute-onset homonymous hemianopia with hyperglycemia: seeing is believing
Roy E Strowd1, Ashley Wabnitz, Nikhil Balakrishnan
1From the Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC.
Abstract:
A 32-year-old woman with a history of bipolar disorder, polycystic ovarian syndrome, and hypertension and a 4-year history of uncontrolled type 2 diabetes mellitus (DM) presented with bifrontal headache, elevated blood sugars (>500 mg/dL), and abrupt-onset left homonymous hemianopia upon awakening. Vital signs included temperature 98.0°F, blood pressure 160/89 mm Hg, and heart rate 67 bpm. Neurologic examination showed dense left homonymous hemianopia with macular sparing and without other focal findings.
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