Kaohsiung Journal of Medical Sciences
Volume 24, Issue 8 , Pages 430-435, August 2008

Homonymous Central Quadrantanopia Caused by an Extrastriate (V2/V3) Infarction: A Case Report

  • Shu-Fang Lin

      Affiliations

    • Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan
    • The first and second authors contributed equally to this work.
  • ,
  • Yu-Ting Kuo

      Affiliations

    • Department of Medicine, Tzu-Chi University, Hualien, Taiwan
    • The first and second authors contributed equally to this work.
  • ,
  • Fang-Ling Chang

      Affiliations

    • Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan
  • ,
  • Rong-Kung Tsai

      Affiliations

    • Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan
    • Department of Ophthalmology and Visual Science, Tzu-Chi University, Hualien, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Rong-Kung Tsai, Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan

Received 30 November 2007; accepted 11 March 2008.

Article Outline

A 66-year-old Taiwanese aboriginal male had complained of right-side blurred vision for 2 months, especially when reading. He had a 10-year history of hypertension and cardiovascular disease. His best-corrected visual acuity was 20/25 in each eye. Ophthalmoscopy revealed asymmetrical cupping, but a normal disc. Humphrey perimetry showed an upper homonymous para-central quadrantanopic defect. Brain magnetic resonance imaging showed an infarction in the left lower calcarine area over the extrastriate (V2/V3) cortical area and a narrowing of the left middle and posterior cerebral arteries due to severe arteriosclerosis.

Key Words:  calcarine fissure , extrastriate cortex , magnetic resonance image , quadrantanopia

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Kitajima M , Korogi Y , Kido T , et al.   MRI in occipital lobe infarcts: classification by involvement of the striate cortex . Neuroradiology . 1998;40:710–715
  2. Hun H . A clinical study of cerebral localization illustrated by seven cases . Am J Med Sci . 1887;93:140–168
  3. Glickstein M , Whitteridge D . Tatsuji Inouye and the mapping of the visual fields on the human cerebral cortex . TINS . 1987;10:350–353
  4. Holmes G . The organization of the visual cortex in men . Proc R Soc Lond Series B (Biol) . 1945;132:348–361
  5. Horton JC , Hoyt WF . The representation of the visual field in human striate cortex. A revision of the classic Holmes map . Arch Ophthalmol . 1991;109:816–824
  6. Horton JC , Hoyt WF . Quadrantic visual field defects: a hallmark of lesions in extrastriate (V2/V3) cortex . Brain . 1991;114:1703–1718
  7. Gattass R , Gross CG , Sandell JH . Visual topography of V2 in the macaque . J Comp Neurol . 1981;201:519–539
  8. Slotnick SD , Moo LR . Retinotopic mapping reveal extrastriate cortical basis of homonymous quadrantanopia . Neuroreport . 2003;14:1209–1213
  9. McFadzean R , Brosnahan D , Hadley D , et al.   Representation of the visual field in the occipital striate cortex . Br J Ophthalmol . 1994;78:185–190
  10. McFadzean R , Hadley D . Homonymous quadrantanopia respecting the horizontal meridian . Neurology . 1997;49:1741–1746
  11. Daniel PM , Whitteridge D . The representation of the visual field on the cerebral cortex in monkeys . J Physiol . 1961;159:203–221
  12. Wong AM , Sharpe JA . A comparison of tangent screen, Goldmann, and Humphrey perimetry in the detection and localization of occipital lesions . Ophthalmology . 2000;107:527–544
  13. Zhang X , Kedar S , Lynn MJ , et al.   Homonymous hemianopias, clinical-anatomic correlations in 904 cases . Neurology . 2006;66:906–910
  14. Jones MR , Waggoner R , Hoyt WF . Cerebral polyopia with extrastriate quadrantanopia: report of a case with magnetic resonance documentation of V2/V3 cortical infarction . J Neuro-ophthalmology . 1999;19:1–6
  15. Gray LG , Galetta SL , Schatz NJ . Vertical and horizontal meridian sparing in occipital lobe homonymous hemianopias . Neurology . 1998;50:1170–1173

PII: S1607-551X(08)70168-2

doi:10.1016/S1607-551X(08)70168-2

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 8 , Pages 430-435, August 2008