Visual hemifield loss in thalamic hematoma

A 45 year old hypertensive patient presented to the emergency medical room (EMR) with sudden onset of severe headache, episode of vomiting, visual loss and confusion. A C.T scan and MRI brain was done revealing a large hematoma in the region of posterior part of left thalamus. The patient was disoriented in time, place and had right visual field hemianopia. The headache and higher functions became normal with control of intracranial pressure and supportive therapy. There were no motor or sensory symptoms or signs. This case is unique as a large thalamic hematoma presented with only visual field deficit and no sensory or motor system affection.