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[Visual disturbances following right cerebral lesion: a case report]
No to Shinkei = Brain and Nerve
|July 1, 1984
Summary
This case study details a patient experiencing distinct visual disturbances, including hemianopsia and visuospatial agnosia, at different times. The findings suggest a potential differentiation between these neurological conditions.
Area of Science:
- Neuroscience
- Neurology
- Cerebrovascular Diseases
Background:
- A 49-year-old male presented with recurrent neurological deficits.
- Initial symptoms included hemiparesis and homonymous hemianopsia due to middle cerebral artery stenosis.
- Subsequent episodes involved transient visual obscurations and later, visuospatial agnosia.
Purpose of the Study:
- To report a unique case of sequential visual disturbances.
- To explore the temporal relationship between hemianopsia and unilateral visuospatial agnosia.
- To investigate the neuroanatomical correlates of these distinct visual deficits.
Main Methods:
- Clinical case presentation and neurological examination.
- Diagnostic imaging including Computed Tomography (CT) and cerebral angiography.
- Surgical intervention: Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis.
Main Results:
- Multiple stenoses of the right middle cerebral artery (MCA) led to initial hemiparesis and hemianopsia.
- Transient visual obscurations occurred, followed by persistent hemianopsia after MCA occlusion.
- Development of left visuospatial agnosia approximately one year after STA-MCA anastomosis, coinciding with posterior cerebral artery (PCA) occlusion.
Conclusions:
- The case highlights the occurrence of hemianopsia and unilateral visuospatial agnosia at separate times.
- This temporal dissociation may aid in differentiating these visual processing disorders.
- Cerebral angiography confirmed progressive occlusive disease affecting both MCA and PCA territories.