Jacobs Journal of Clinical Case Reports

Bilateral Superior Altitudinal Hemianopia of Uncommon Origin: A Case Report of a Hemorrhagic Stroke Patient

*Renato Avesani
Department Of Rehabilitation, Italy

*Corresponding Author:
Renato Avesani
Department Of Rehabilitation, Italy

Published on: 2018-02-19


This paper describes the case of a woman that showed bilateral altitudinal superior hemianopia after having an tetraventricular hemorrhagic stroke. While in the majority of cases the etiology of the “neurological picture” above is cardio-embolic or atherosclerotic, in the case of the woman it could be the damage of the Meyer loop caused by hemosiderin deposits. Data available in the scientific literature on this pathology is very scant and is given mainly by “case reports” of patients with occipital infarctions (PCA region). To the best of our knowledge, it is the first case described in the literature of bilateral altitudinal hemianopia with this type of origin, so this manuscript could improve the knowledge of the origin of this uncommon neurological presentation.


Altitudinal Hemianopia; Stroke; Cerebral Hemorrhage; Meyer Loop


Bilateral superior altitudinal hemianopia is a very uncommon clinical presentation in patients with stroke. Data available in the scientific literature is very scant and, in the majority of cases, only “case reports” of patients with cardio-embolic or atherosclerotic brain infarctions are described [1-5]. In January 2015 a Computerized Tomography (CT) scan demonstrated a tetraventicular hemorrhage in a 26 years old woman who arrived in Emergency Room of the Verona Hospital (Italy). No risk factors nor vascular malformations emerged from medical history and imaging studies (cerebral angiography and magnetic resonance angiography) performed during her Neurosurgery stay. The patient underwent to implantation of external ventricular drainage to reduce intracranial hypertension.