Bilateral Homonymous Hemianopia with Sparing of the Vertical Meridian

Abstract

A 19-year-old woman, who was 16 weeks post partum, collapsed with loss of consciousness. Following awakening she suffered abrupt loss of vision. Partial recovery occurred, although she has been left with bilateral homonymous hemianopia with sparing of vision just to the left of the vertical meridian. Magnetic resonance imaging demonstrated bilateral occipital infarcts, sparing the lips of the calcarine sulcus on the right. This is compatible with our expectation that the vertical meridian of the retinotopic map is represented at the superior and inferior lips of the calcarine sulcus.

Neurological Visual Field Defects

“…74 Complete cortical blindness can result, 1 which may be accompanied by Anton's syndrome, a form of anosognosia, where the patient denies being blind. 75 As in unilateral calcarine infarction, partial sparing of vision in larger defects 1,3,4,6,46,[67][68][69]71,72,76,77 or partial visual field defects 1,3,4,6,46,50,68,69 can result, both of which may be asymmetrical. This is due to the anatomical distribution of the lesion, or due to asymmetrical arterial supply to each of the calcarine cortices.…”