Background: A visual field defect is the most important neurologic defect in occipital lobe infarcts. There are only sporadic case reports of altitudinal hemianopia in the published data. We report a patient with bilateral superior altitudinal hemianopia.
Case report: A 40-year-old man developed bilateral superior altitudinal hemianopia secondary to bilateral parahippocampal and fusiform gyrus lesions. Vision loss was acute, and onset bilateral and simultaneous. Complete neuro-ophthalmologic examinations were performed. His best corrected visual acuity was 20/20 in each eye. Macula and retina examinations were normal. Visual fields were characterized by bilateral upper hemianopia. Cerebral magnetic resonance imaging (MRI) confirmed the presence of symmetrical lesions confined within both bilateral parahippocampal and fusiform gyri. Blood tests, transesophageal echocardiographic examination, and Doppler ultrasonography of the vertebrobasilar arterial system and carotids were normal.
Conclusion: We conclude that embolic events may induce a bilateral superior altitudinal hemianopia.