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Neuroanatomy
Published in Helen Butler, Neel Sharma, Tiago Villanueva, Student Success in Anatomy - SBAs and EMQs, 2022
For each of the following scenarios described, select the most appropriate answer from the above list of options. Each option may be used once, more than once or not at all. Visual field examination demonstrating a superior quadrantanopia.A man presenting with ‘tunnel vision' and found on examination to have a bitemporal hemianopia.A 3 3 -year-old woman complaining of double vision. On examination she is unable to abduct her left eye.On shining a light into the right eye, the left pupil constricts, while the right does not.A 78-year-old man in the stroke unit with an inferior quadrantanopia.
Examine the cranial nerves
Published in Hani TS Benamer, Neurology for MRCP PACES, 2019
Assessment of the visual field by confrontation can be crude. Therefore it is less likely that you will get patients with superior quadrantanopia (temporal lobe lesion) or inferior quadrantanopia (parietal lobe lesion).
MRCPsych Paper A1 Mock Examination 4: Answers
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
Scotoma is defined as an area of reduced vision (e.g. central scotoma) and is commonly caused by demyelinating diseases such as multiple sclerosis or macular degeneration. Hemianopia is defined as loss of half of visual field of both eyes (either left side or right side). Damage to the right posterior portion of the brain usually causes a loss of the left half of visual fields in both eyes. Similarly, damage to the left posterior brain usually causes a loss of right half of visual fields in both eyes. Homonymous quadrantanopia is defined as loss of either outer upper or lower quadrant of visual field of one eye. For example, left superior homonymous quadrantanopia is caused by right temporal lobe lesion. Bitemporal hemianopia is defined as loss of outer half of visual fields in both eyes and is commonly caused by pituitary tumour.
Glioblastoma evolving within 10 days following unremarkable computer tomography of the brain: a case report
Published in International Journal of Neuroscience, 2021
Nils Schröter, Niklas Lützen, Soroush Doostkam, Benjamin Berger
Ten days later, the patient presented to our department with persistent hemiparesis of the right side and quadrantanopia of the right lower quadrant. CT scan of the brain showed a hemorrhagic space-occupying lesion in the left thalamus without vascular abnormalities on CT angiography (Figure 1(b,c)). In order to neutralize apixaban efficacy 3000 IE prothrombin complex (PPSB) were given. MRI of the brain another six days later revealed a lesion with ring-shaped gadolinium enhancement with central necrotic and partly hemorrhagic areas (Figure 1(d,e)), but without diffusion restriction (not shown in Figure 1), suggesting a high-grade glioma rather than an abscess. However, histological examination of a stereotactic biopsy showed predominantly reactive gliotic CNS tissue, fibrin, fresh hemorrhages, necrotic material and regionally also macrophages and numerous granulocytes. Due to the necrosis and granulocytic infiltrates as well as the lack of tumor detection, the diagnosis of an abscess was made (Figure 2(a–f)). However, microbiological pathogens could not be detected. Furthermore, screening for infectious foci (transthoracic and transesophageal echocardiography, dental examination including panoramic X-ray, X-ray of the thorax, CT of paranasal sinuses) or predisposing immunodeficiency (differential blood count, HIV serology and immunoglobulin levels) was unremarkable. Under the assumption of a cerebral abscess an empiric antibiotic therapy with metronidazole and ceftriaxone was initiated.
Occipital lobe epilepsy was presented in a patient with intracerebral schwannoma: a case report and literature review
Published in International Journal of Neuroscience, 2019
Hirotomo Ten, Koji Adachi, Fumio Yamaguchi, Akira Matsuno, Akira Teramoto, Akio Morita
A 19-year-old man, with no significant past history and no stigmata or family history of neurofibromatosis, has suffered from intermittent blurred vision with scintillation in his right visual field for 10–30 s, followed by headache over his occipital region once in a month since 3 years ago. He had no convulsive seizures with consciousness impairment. Brain MRI performed in local hospital demonstrated brain tumor and then the patient was referred to our hospital for further evaluation and treatments. Upon admission, his consciousness was clear without limb paralysis or paresthesia. The physical examination showed incomplete right inferior quadrantanopia, which was confirmed by perimeter, but no other positive findings.
Transient vision loss: a neuro-ophthalmic approach to localizing the diagnosis
Published in Expert Review of Ophthalmology, 2018
Helen Chung, Jodie M. Burton, Fiona E. Costello
From a more specific ophthalmic perspective, it is important to check ‘the basics’ of afferent visual function, including: visual acuity, pupillary responses (presence or absence of a relative afferent pupillary defect), color vision, and visual field assessment. High contrast visual acuity is a relatively crude measure of visual function in disorders of the optic nerve, as it can be preserved in the setting of significant color vision loss and visual field dysfunction. Nonetheless, a decrease in visual acuity could implicate a chronic process, such a compressive optic neuropathy causing vision loss that the patient is only transiently aware of; or, evidence of prior demyelinating injury, which may be the basis of Uhthoff’s phenomenon (TVL provoked by increased body temperature). Disproportionate color vision loss relative to high contrast visual acuity function can be a hallmark of optic neuropathies, particularly those due to a compressive mechanism. Visual field testing with formal perimetry may provide clues to the underlying diagnosis. Enlarged blind spots can provide evidence of raised ICP, whereas glaucomatous field changes, such as nasal steps or arcuate defects, could indicate an underlying pigment dispersion syndrome or intermittent angle closure. Transient altitudinal visual field defects can signify an increased risk for carotid disease as a basis of transient monocular vision loss[3]. It is noteworthy that patients with fixed visual field defects detected by examination may sometimes report transient awareness of the problem. For example, a patient with a superior quadrantanopia may not be aware of the vision loss until he or she engages in an activity such as volleyball, for example, during which time this visual field defect would potentially impair play.