Acute Splenial Hemianopsia: A rare Case Report
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Abstract
We present the case of a 76-year-old woman admitted with acute-onset right parietal headache, left-sided visual field impairment, and gait imbalance, in the context of a hypertensive peak. Neurological examination revealed a left homonymous hemianopia. Cranial CT identified a recent ischemic lesion in the right splenium of the corpus callosum and right occipital cortex. MRI confirmed a subacute infarct in the right posterior cerebral artery (PCA) territory, with occlusion of the distal P2 segment. The patient remained hemodynamically and neurologically stable during a four-day hospitalization, with spontaneous improvement in visual symptoms and full return to baseline functional status (mRS 0). No arrhythmias were detected on 24-hour Holter monitoring. She was discharged on secondary prevention therapy with aspirin, atorvastatin, and ramipril. A repeat MRI performed 18 months later confirmed the chronic evolution of the infarct. This case highlights the variable clinical presentation of PCA strokes and the importance of comprehensive diagnostic work-up, even in patients with full clinical recovery.
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