Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

Neurology. 2022 Oct 18;99(16):713-717. doi: 10.1212/WNL.0000000000201175. Epub 2022 Aug 29.

Abstract

An 80-year-old woman who was experiencing visual symptoms for 2 years was found to have a left homonymous hemianopsia (HH). On further evaluation the following month, she was noted to have simultanagnosia and alexia. MRI of the brain did not reveal a structural etiology for the symptoms. [18F]-fluorodeoxyglucose (FDG) PET-CT was performed to aid in the diagnostic investigation. This case of posterior cortical atrophy highlights the differential diagnosis of a HH in the absence of a structural lesion on MRI and the role of FDG PET-CT imaging in such patients.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Clinical Reasoning
  • Female
  • Fluorodeoxyglucose F18*
  • Hemianopsia* / diagnostic imaging
  • Hemianopsia* / etiology
  • Humans
  • Magnetic Resonance Imaging / adverse effects
  • Positron Emission Tomography Computed Tomography

Substances

  • Fluorodeoxyglucose F18