Bilateral inferior altitudinal hemianopia

Altitudinal, upper or usually lower hemianopia may be mostly uni- but also bilateral and spare the horizontal meridian as well as macular vision. An 81-year-old man suddenly developed complete bilateral inferior altitudinal hemianopia, sparing the macular area on the one side but involving macular vision on the other. The ophthalmological examination revealed further nothing abnormal: open angle glaucomatous disease was ruled out. A repeat CT-scan of the brain, 12 days after onset of the neuro-ophthalmological condition, showed in addition a bilateral cortical occipital infarction. On the CT-scan, before the onset of the latter condition, a hematoma in the right thalamus, with hemorrhage into the right frontal conus and third ventricle had been diagnosed in a patient with only mild left hemiparesis.