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NEUROLOGY 2006;66:E41-E42
© 2006 American Academy of Neurology
Resident and Fellow Page

Geniculate quadruple sectoranopia

Benjamin J. Osborne, MD, Grant T. Liu, MD and Steven L. Galetta, MD

From the Department of Neurology, University of Pennsylvania, Philadelphia.

Address correspondence and reprint requests to Dr. Steven L. Galetta, Department of Neurology, 3 Ravdin, Department of Neurology, University of Pennsylvania Hospital, Philadelphia, PA 19004; e-mail: galetta{at}mail.med.upenn.edu

Quadruple sectoranopias are wedge-shaped visual field defects that can be caused by lesions in the medial and lateral portions of the lateral geniculate body.1 By definition, there is involvement of two homonymous segments of each hemi-field. The etiology is typically an occlusion of the anterior choroidal artery. Its counterpart, the horizontal sectoranopia, is produced by lesions of the geniculate hilum, an area supplied by the lateral choroidal artery (figure 1).


Figure 155
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  		Figure 1. Anatomy of blood supply to lateral geniculate body.

 

A 24-year-old man developed acute onset of blurred vision and headache. Examination revealed an isolated left homonymous hemianopia.

Brain MRI demonstrated acute intraparenchymal hemorrhage including the right lateral geniculate body (figure 2). Magnetic resonance angiography and cerebral angiogram showed abnormal vessels in the right ambient cistern, suggestive of an arteriovenous malformation.


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  		Figure 2. T2 axial MRI demonstrating high signal abnormality involving the right lateral geniculate nucleus.

 

Humphrey 30-2 visual fields showed a left homonymous quadruple sectoranopia (figure 3).


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  		Figure 3. Humphrey visual field demonstrating left quadruple sectoranopia.

 

Footnotes

Disclosure: The authors report no conflicts of interest.

Reference

  1. Frisen L. Quadruple sectoranopia and sectorial optic atrophy: a syndrome of the distal anterior choroidal artery. J Neurol Neurosurg Psychiatry 1979;42:590–594.[Abstract]




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