Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Incongruous homonymous quadrantanopia due to suprasellar calcificated lesions

Yukio Sugiyama, M.D.1), Hiroshi Moriwaki, M.D.1), Satoshi Imakita, M.D.2), Naoaki Yamada, M.D.2), Masanobu Tanaka, M.D.3) and Hiroaki Naritomi, M.D.1)

1)Department of Cerebrovascular Medicine, 2)Department of Radiology, 3)Department of Ophthalmology, National Cardiovascular Center

A 53 year-old woman with a history of tuberculous meningitis at 3 years of age incidentally found a right incongruous homonymous quadrantanopia in ophthalmologic check-up. On magnetic resonance imaging and helical computed tomography, the left optic tract was obscured by suprasellar calcified lesions. The left internal carotid artery was diffusely narrowed and occluded at its terminal portion as demonstrated by cerebral angiography. The calcificated lesions were diagnosed to derive from old tuberculous meningitis on the basis of her history, their location and the association of vascular occlusive changes. Incongruous homonymous hemianopsia due to optic tract damage is usually caused by tumor or aneurysm. Its occurrence by calcified inflammatory lesions has never been reported previously. The present case is considered of value in this respect.

(CLINICA NEUROL, 45: 590|595, 2005)
key words: homonymous quadrantanopia, optic tract, calcificated lesion, internal carotid artery occlusion, tuberculous meningitis

(Received: 5-Nov-04)