Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Incongruous, incomplete, homonymous hemianopia due to an infarction localized to the lateral geniculate body

Kanta Tanaka, M.D.1)2), Ikko Wada, M.D.1) and Toshihiko Suenaga, M.D., Ph.D.1)

1)Department of Neurology, Tenri Hospital
2)Stroke Center, Tenri Hospital

A 45-year-old male was admitted with an acute-onset visual field defect. Goldmann perimetry revealed an incongruent, incomplete right homonymous hemianopia. The left eye showed a wedge-shaped, horizontal right hemianopia, whereas the right eye showed constriction of the right visual hemifield. MRI showed acute infarction localized to the left lateral geniculate body (LGB). LGB has a dual blood supply: from the anterior choroidal artery and from the lateral posterior choroidal artery (LPChA). The LPChA territory of LGB receives projection from the retinal area around the macula and horizontal meridian. Therefore, an LPChA territory infarction of LGB can cause a wedgeshaped, horizontal visual field defect. The visual field defect in our patient would be caused by an LPChA territory infarction of LGB. Our patient showed an incongruent homonymous hemianopia. LGB has six laminae, with the ipsilateral retinal fibers terminating in layers two, three, and five and the crossed fibers terminating in layers one, four, and six. The laminar structure provides the anatomical basis for the incongruous visual field defects in a case of partial lesion of LGB. Based on the present data, we believe that an ischemic lesion localized to LGB should be considered in patients presenting with incongruous, incomplete homonymous hemianopia.
Full Text of this Article in Japanese PDF (1169K)

(CLINICA NEUROL, 57: 595|598, 2017)
key words: sectoranopia, wedge-shaped visual field defect, congruency, lateral geniculate body, lateral posterior choroidal artery

(Received: 11-May-17)