Case 182 Answers

Basic Human Neuroanatomy

A Clinically Oriented Atlas

Case 182 Answers_Follow-Up Visit: 1-3-1984

1. In view of the above clinical course, is there a change in your working diagnosis concerning the patient’s initial head pain and diplopia? If so, what is your tentative diagnosis of those findings at this point?

2. How would you describe this patient’s visual findings?

Right superior homonymous quadrantanopsia

3. Concerning the new visual symptoms, indicate the specific structures involved in producing these signs and symptoms. Indicate the most likely anatomical location of the lesion. Is there only one anatomical location that can produce these visual signs and symptoms? If so, what is that location? If not, what are the possible locations of such a lesion?

1. Temporal loop of the left optic radiations in the left temporal lobe.
2. Left lingual gyrus (lower bank of the calcarine sulcus), in the occipital lobe.

4. Concerning the patient’s new visual findings, what general type of pathologic process do you think was involved in producing these findings?

Vascular – probably a partial left posterior cerebral artery (PCA) infarct

5. Are there any additional diagnostic procedures that you would like to undertake at this point?

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